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Published in: BMC Public Health 1/2018

Open Access 01-12-2018 | Research article

A tailored within-community specimen collection strategy increased uptake of cervical cancer screening in a cross-sectional study in Ghana

Authors: Adolf K. Awua, Edwin K. Wiredu, Edwin A. Afari, Ahmad S. Tijani, Gabriel Djanmah, Richard M. K. Adanu

Published in: BMC Public Health | Issue 1/2018

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Abstract

Background

The implementation of cervical cancer screening strategies has reported different rates of success in different countries due to population specific factors that limit women’s participation. We report observations and the development of a community-based specimen collection strategy which resulted from interactions with women in the study communities, following an initial low response to a hospital based cervical cancer screening strategy.

Method

Women were recruited by a house survey and invited to report at a hospital either within a week or after a week for self and health-personnel specimen collections. However, due to the very low response and subsequent interactions with the women of the communities, another strategy was developed that required recruited women report at a central location within their respective communities for specimen collections at times that did not interfere with their daily routines.

Results

For specimen collection, of the 156 participants who opted to report after a week at the hospital, 60 (38.5%) reported. Of the 118 participants who opted to report within 1 week at the hospital, 55 (46.6%) reported. Of the 103 participants were invited to report at a specified location within the community, 98 (95.1%) reported. An overall response rate of 60.4% was attained. Almost 89.7% (226 of 253) of the women performed both self and health personnel sample collection.

Conclusion

The community-based strategy with self-specimen collection and HPV testing holds great potential for increasing women’s participation in cervical cancer screening in Ghana as compared to the hospital based strategy.
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Literature
1.
go back to reference GLOBOCAN, IARC. (2012) GLOBOCAN 2012: estimated cancer incidence, mortality and prevalence worldwide in 2012; Fact Sheets. GLOBOCAN, IARC. (2012) GLOBOCAN 2012: estimated cancer incidence, mortality and prevalence worldwide in 2012; Fact Sheets.
3.
go back to reference Awua AK, Sackey ST, Osei YD, Asmah RH, Wiredu EK. Prevalence of human papillomavirus genotypes among women with cervical cancer in Ghana. Infectious Agents and Cancer. 2016;11:4 Awua AK, Sackey ST, Osei YD, Asmah RH, Wiredu EK. Prevalence of human papillomavirus genotypes among women with cervical cancer in Ghana. Infectious Agents and Cancer. 2016;11:4
4.
go back to reference Scarinci, I. C., Garcia, F. A. R., Kobetz, E., Partridge, E. E., Brandt, H. M., Bell, M. C., Dignan, M., Ma, G. X., Daye, J. L. and Castle, P. E. Cervical cancer prevention. Cancer 2010;116(1):31–42. Scarinci, I. C., Garcia, F. A. R., Kobetz, E., Partridge, E. E., Brandt, H. M., Bell, M. C., Dignan, M., Ma, G. X., Daye, J. L. and Castle, P. E. Cervical cancer prevention. Cancer 2010;116(1):31–42.
5.
go back to reference Lowy DR, Solomon D, Hildesheim A, Schiller JT, Schiffman M. Human papillomavirus infection and the primary and secondary prevention of cervical cancer. Cancer. 2008;113:1980–93.CrossRefPubMed Lowy DR, Solomon D, Hildesheim A, Schiller JT, Schiffman M. Human papillomavirus infection and the primary and secondary prevention of cervical cancer. Cancer. 2008;113:1980–93.CrossRefPubMed
6.
go back to reference Mayrand M-H, Duarte-Franco E, Rodrigues I, Walter SD, Hanley J, Ferenczy A, Ratnam S, Coutlée F, Franco EL. Human papillomavirus DNA versus Papanicolaou screening tests for cervical cancer. N Engl J Med. 2007;357:1579–88.CrossRefPubMed Mayrand M-H, Duarte-Franco E, Rodrigues I, Walter SD, Hanley J, Ferenczy A, Ratnam S, Coutlée F, Franco EL. Human papillomavirus DNA versus Papanicolaou screening tests for cervical cancer. N Engl J Med. 2007;357:1579–88.CrossRefPubMed
7.
go back to reference Escoffery C, Rodgers KC, Kegler MC, Haardörfer R, Howard DH, Liang S, Pinsker E, Roland KB, Allen JD, Ory MG, et al. A systematic review of special events to promote breast, cervical and colorectal cancer screening in the United States. BMC Public Health. 2014;14:274.CrossRefPubMedPubMedCentral Escoffery C, Rodgers KC, Kegler MC, Haardörfer R, Howard DH, Liang S, Pinsker E, Roland KB, Allen JD, Ory MG, et al. A systematic review of special events to promote breast, cervical and colorectal cancer screening in the United States. BMC Public Health. 2014;14:274.CrossRefPubMedPubMedCentral
8.
go back to reference Moses, E., Pedersen, H. N., Mitchell, S. M., Sekikubo, M., Mwesigwa, D., Singer, J., Biryabarema, C., Byamugisha, J. K., Money, D. M. and Ogilvie, G. S. Uptake of community-based, self-collected HPV testing versus visual inspection with acetic acid for cervical cancer screening in Kampala, Uganda: preliminary results of a randomised controlled trial. Tropical Medicine & International Health. 2015;20(10):55–67. Moses, E., Pedersen, H. N., Mitchell, S. M., Sekikubo, M., Mwesigwa, D., Singer, J., Biryabarema, C., Byamugisha, J. K., Money, D. M. and Ogilvie, G. S. Uptake of community-based, self-collected HPV testing versus visual inspection with acetic acid for cervical cancer screening in Kampala, Uganda: preliminary results of a randomised controlled trial. Tropical Medicine & International Health. 2015;20(10):55–67.
9.
go back to reference Quentin W, Adu-Sarkodie Y, Terris-Prestholt F, Legood R, Opoku BK, Mayaud P. Costs of cervical cancer screening and treatment using visual inspection with acetic acid (VIA) and cryotherapy in Ghana: the importance of scale: costs of cervical cancer screening in Ghana. Tropical Med Int Health. 2011;16:379–89.CrossRef Quentin W, Adu-Sarkodie Y, Terris-Prestholt F, Legood R, Opoku BK, Mayaud P. Costs of cervical cancer screening and treatment using visual inspection with acetic acid (VIA) and cryotherapy in Ghana: the importance of scale: costs of cervical cancer screening in Ghana. Tropical Med Int Health. 2011;16:379–89.CrossRef
10.
go back to reference Sankaranarayanan R, Gaffikin L, Jacob M, Sellors J, Robles S. A critical assessment of screening methods for cervical neoplasia. Int J Gynecol Obstet. 2005;89:S4–S12.CrossRef Sankaranarayanan R, Gaffikin L, Jacob M, Sellors J, Robles S. A critical assessment of screening methods for cervical neoplasia. Int J Gynecol Obstet. 2005;89:S4–S12.CrossRef
11.
go back to reference Gaffikin L, McGrath JA, Arbyn M, Blumenthal PD. Visual inspection with acetic acid as a cervical cancer test: accuracy validated using latent class analysis. BMC Med Res Methodol. 2007;7:36.CrossRefPubMedPubMedCentral Gaffikin L, McGrath JA, Arbyn M, Blumenthal PD. Visual inspection with acetic acid as a cervical cancer test: accuracy validated using latent class analysis. BMC Med Res Methodol. 2007;7:36.CrossRefPubMedPubMedCentral
12.
go back to reference Mezei, A. K., Armstrong, H. L., Pedersen, H. N., Campos, N. G., Mitchell, S. M., Sekikubo, M., Byamugisha, J. K., Kim, J. J., Bryan, S. and Ogilvie, G. S. Cost-effectiveness of cervical cancer screening methods in low- and middle-income countries: a systematic review: cervical cancer in LMICs. International Journal of Cancer. 2017;141(3):437–446. Mezei, A. K., Armstrong, H. L., Pedersen, H. N., Campos, N. G., Mitchell, S. M., Sekikubo, M., Byamugisha, J. K., Kim, J. J., Bryan, S. and Ogilvie, G. S. Cost-effectiveness of cervical cancer screening methods in low- and middle-income countries: a systematic review: cervical cancer in LMICs. International Journal of Cancer. 2017;141(3):437–446.
13.
go back to reference Sherpa P, Pant A. Correlation of visual inspection with cytological and histopathological findings in cervical neoplasia. J Pathol Nepal. 2017;7:1070.CrossRef Sherpa P, Pant A. Correlation of visual inspection with cytological and histopathological findings in cervical neoplasia. J Pathol Nepal. 2017;7:1070.CrossRef
14.
go back to reference Marimuthu K, Loganathan M. Comparing the efficacy of visual inspection with acetic acid and lugol’s iodine as a screening tool for detecting cervical lesions in asymptomatic women of reproductive age group with colposcopy and biopsy in a tertiary care hospital. Int J Repro Contracept Obstet and Gynecol. 2017;6:1766.CrossRef Marimuthu K, Loganathan M. Comparing the efficacy of visual inspection with acetic acid and lugol’s iodine as a screening tool for detecting cervical lesions in asymptomatic women of reproductive age group with colposcopy and biopsy in a tertiary care hospital. Int J Repro Contracept Obstet and Gynecol. 2017;6:1766.CrossRef
15.
go back to reference Masalu N, Serra P, Amadori D, Kahima J, Majinge C, Rwehabura J, Nanni O, Bravaccini S, Puccetti M, Tumino R, et al. Setting up a community-based cervical screening service in a low-income country: a pilot study from north-western Tanzania: International Journal of Public Health; 2017. https://doi.org/10.1007/s00038-017-0971-8. Masalu N, Serra P, Amadori D, Kahima J, Majinge C, Rwehabura J, Nanni O, Bravaccini S, Puccetti M, Tumino R, et al. Setting up a community-based cervical screening service in a low-income country: a pilot study from north-western Tanzania: International Journal of Public Health; 2017. https://​doi.​org/​10.​1007/​s00038-017-0971-8.
16.
go back to reference Shi J-F, Canfell K, Lew J-B, Zhao F-H, Legood R, Ning Y, Simonella L, Ma L, Kang Y-J, Zhang Y-Z, et al. Evaluation of primary HPV-DNA testing in relation to visual inspection methods for cervical cancer screening in rural China: an epidemiologic and cost-effectiveness modelling study. BMC Cancer. 2011;11:239. Shi J-F, Canfell K, Lew J-B, Zhao F-H, Legood R, Ning Y, Simonella L, Ma L, Kang Y-J, Zhang Y-Z, et al. Evaluation of primary HPV-DNA testing in relation to visual inspection methods for cervical cancer screening in rural China: an epidemiologic and cost-effectiveness modelling study. BMC Cancer. 2011;11:239.
17.
go back to reference Sankaranarayanan R, Nessa A, Esmy PO, Dangou J-M. Visual inspection methods for cervical cancer prevention. Best Prac Res Clin Obstet Gynaecol. 2012;26:221–32.CrossRef Sankaranarayanan R, Nessa A, Esmy PO, Dangou J-M. Visual inspection methods for cervical cancer prevention. Best Prac Res Clin Obstet Gynaecol. 2012;26:221–32.CrossRef
18.
go back to reference Castle PE, Rausa A, Walls T, Gravitt PE, Partridge EE, Olivo V, Niwa S, Morrissey KG, Tucker L, Katki H, et al. Comparative community outreach to increase cervical cancer screening in the Mississippi Delta. Prev Med. 2011;52:452–5.CrossRefPubMedPubMedCentral Castle PE, Rausa A, Walls T, Gravitt PE, Partridge EE, Olivo V, Niwa S, Morrissey KG, Tucker L, Katki H, et al. Comparative community outreach to increase cervical cancer screening in the Mississippi Delta. Prev Med. 2011;52:452–5.CrossRefPubMedPubMedCentral
19.
go back to reference Aiko K-Y, Yoko M, Saito OM, Ryoko A, Yasuyo M, Mikiko A-S, Takeharu Y, Fumiki H, Etsuko M. Accuracy of self-collected human papillomavirus samples from Japanese women with abnormal cervical cytology: HPV self-test for Japanese women. J Obstet Gynaecol Res. 2017;43:710–7.CrossRefPubMed Aiko K-Y, Yoko M, Saito OM, Ryoko A, Yasuyo M, Mikiko A-S, Takeharu Y, Fumiki H, Etsuko M. Accuracy of self-collected human papillomavirus samples from Japanese women with abnormal cervical cytology: HPV self-test for Japanese women. J Obstet Gynaecol Res. 2017;43:710–7.CrossRefPubMed
20.
go back to reference Virtanen A, Nieminen P, Luostarinen T, Anttila A. Self-sample HPV tests as an intervention for nonattendees of cervical cancer screening in Finland: a randomized trial. Cancer Epidemiol Biomark Prev. 2011;20:1960–9.CrossRef Virtanen A, Nieminen P, Luostarinen T, Anttila A. Self-sample HPV tests as an intervention for nonattendees of cervical cancer screening in Finland: a randomized trial. Cancer Epidemiol Biomark Prev. 2011;20:1960–9.CrossRef
21.
go back to reference Rossi PG, Marsili LM, Camilloni L, Iossa A, Lattanzi A, Sani C, Di Pierro C, Grazzini G, Angeloni C, Capparucci P, et al. The effect of self-sampled HPV testing on participation to cervical cancer screening in Italy: a randomised controlled trial (ISRCTN96071600). Br J Cancer. 2011;104:248–54.CrossRef Rossi PG, Marsili LM, Camilloni L, Iossa A, Lattanzi A, Sani C, Di Pierro C, Grazzini G, Angeloni C, Capparucci P, et al. The effect of self-sampled HPV testing on participation to cervical cancer screening in Italy: a randomised controlled trial (ISRCTN96071600). Br J Cancer. 2011;104:248–54.CrossRef
22.
go back to reference Gok, M., Heideman, D. A. M., van Kemenade, F. J., Berkhof, J., Rozendaal, L., Spruyt, J. W. M., Voorhorst, F., Belien, J. A. M., Babovic, M., Snijders, P. J. F., et al. (2010) HPV testing on self collected cervicovaginal lavage specimens as screening method for women who do not attend cervical screening: cohort study. BMJ 340, c1040–c1040. Gok, M., Heideman, D. A. M., van Kemenade, F. J., Berkhof, J., Rozendaal, L., Spruyt, J. W. M., Voorhorst, F., Belien, J. A. M., Babovic, M., Snijders, P. J. F., et al. (2010) HPV testing on self collected cervicovaginal lavage specimens as screening method for women who do not attend cervical screening: cohort study. BMJ 340, c1040–c1040.
23.
go back to reference Sanner K, Wikström I, Strand A, Lindell M, Wilander E. Self-sampling of the vaginal fluid at home combined with high-risk HPV testing. Br J Cancer. 2009;101:871–4.CrossRefPubMedPubMedCentral Sanner K, Wikström I, Strand A, Lindell M, Wilander E. Self-sampling of the vaginal fluid at home combined with high-risk HPV testing. Br J Cancer. 2009;101:871–4.CrossRefPubMedPubMedCentral
24.
go back to reference Adanu RMK, Seffah JD, Duda R, Darko R, Hill A, Anarfi J. Clinic visits and cervical cancer screening in accra. Ghana Med J. 2010;44:59–63.PubMedPubMedCentral Adanu RMK, Seffah JD, Duda R, Darko R, Hill A, Anarfi J. Clinic visits and cervical cancer screening in accra. Ghana Med J. 2010;44:59–63.PubMedPubMedCentral
25.
go back to reference WHO/ICO Information Centre on Human Papillomavirus and Cervical Cancer. (2010) Human Papillomavirus and Related Cancers in Ghana., Summary Report. WHO/ICO Information Centre on Human Papillomavirus and Cervical Cancer. (2010) Human Papillomavirus and Related Cancers in Ghana., Summary Report.
26.
go back to reference Scarinci IC, Litton AG, Garcés-Palacio IC, Partridge EE, Castle PE. Acceptability and usability of self-collected sampling for HPV testing among African-American women living in the Mississippi Delta. Womens Health Issues. 2013;23:e123–30.CrossRefPubMedPubMedCentral Scarinci IC, Litton AG, Garcés-Palacio IC, Partridge EE, Castle PE. Acceptability and usability of self-collected sampling for HPV testing among African-American women living in the Mississippi Delta. Womens Health Issues. 2013;23:e123–30.CrossRefPubMedPubMedCentral
27.
go back to reference Ogilvie GS, Mitchell S, Sekikubo M, Biryabarema C, Byamugisha J, Jeronimo J, Miller D, Steinberg M, Money DM. Results of a community-based cervical cancer screening pilot project using human papillomavirus self-sampling in Kampala, Uganda. Int J Gynecol Obstet. 2013;122:118–23.CrossRef Ogilvie GS, Mitchell S, Sekikubo M, Biryabarema C, Byamugisha J, Jeronimo J, Miller D, Steinberg M, Money DM. Results of a community-based cervical cancer screening pilot project using human papillomavirus self-sampling in Kampala, Uganda. Int J Gynecol Obstet. 2013;122:118–23.CrossRef
28.
go back to reference Arrossi S, Thouyaret L, Herrero R, Campanera A, Magdaleno A, Cuberli M, Barletta P, Laudi R, Orellana L. Effect of self-collection of HPV DNA offered by community health workers at home visits on uptake of screening for cervical cancer (the EMA study): a population-based cluster-randomised trial. Lancet Glob Health. 2015;3:e85–94.CrossRefPubMed Arrossi S, Thouyaret L, Herrero R, Campanera A, Magdaleno A, Cuberli M, Barletta P, Laudi R, Orellana L. Effect of self-collection of HPV DNA offered by community health workers at home visits on uptake of screening for cervical cancer (the EMA study): a population-based cluster-randomised trial. Lancet Glob Health. 2015;3:e85–94.CrossRefPubMed
29.
go back to reference Ghana Statistical Service. (2010) Ghana National Census, 2010. Ghana Statistical Service. (2010) Ghana National Census, 2010.
30.
go back to reference Thomas JO, Herrero R, Omigbodun AA, Ojemakinde K, Ajayi IO, Fawole A, Oladepo O, Smith JS, Arslan A, Muñoz N, et al. Prevalence of papillomavirus infection in women in Ibadan, Nigeria: a population-based study. Br J Cancer. 2004;90:638–45.CrossRefPubMedPubMedCentral Thomas JO, Herrero R, Omigbodun AA, Ojemakinde K, Ajayi IO, Fawole A, Oladepo O, Smith JS, Arslan A, Muñoz N, et al. Prevalence of papillomavirus infection in women in Ibadan, Nigeria: a population-based study. Br J Cancer. 2004;90:638–45.CrossRefPubMedPubMedCentral
31.
go back to reference Snijders PJF, Verhoef VMJ, Arbyn M, Ogilvie G, Minozzi S, Banzi R, van Kemenade FJ, Heideman DAM, Meijer CJLM. High-risk HPV testing on self-sampled versus clinician-collected specimens: a review on the clinical accuracy and impact on population attendance in cervical cancer screening. Int J Cancer. 2013;132:2223–36.CrossRefPubMed Snijders PJF, Verhoef VMJ, Arbyn M, Ogilvie G, Minozzi S, Banzi R, van Kemenade FJ, Heideman DAM, Meijer CJLM. High-risk HPV testing on self-sampled versus clinician-collected specimens: a review on the clinical accuracy and impact on population attendance in cervical cancer screening. Int J Cancer. 2013;132:2223–36.CrossRefPubMed
32.
go back to reference Scarinci, I. C., Garcia, F. A. R., Kobetz, E., Partridge, E. E., Brandt, H. M., Bell, M. C., Dignan, M., Ma, G. X., Daye, J. L. and Castle, P. E. Cervical cancer prevention: new tools and old barriers. Cancer. 2010;116(1):31–42. Scarinci, I. C., Garcia, F. A. R., Kobetz, E., Partridge, E. E., Brandt, H. M., Bell, M. C., Dignan, M., Ma, G. X., Daye, J. L. and Castle, P. E. Cervical cancer prevention: new tools and old barriers. Cancer. 2010;116(1):31–42.
33.
go back to reference Berner A, Hassel SB, Tebeu P-M, Untiet S, Kengne-Fosso G, Navarria I, Boulvain M, Vassilakos P, Petignat P. Human papillomavirus self-sampling in Cameroon: Women’s uncertainties over the reliability of the method are barriers to acceptance. J Low Genit Tract Dis. 2013;17:235–41.CrossRefPubMed Berner A, Hassel SB, Tebeu P-M, Untiet S, Kengne-Fosso G, Navarria I, Boulvain M, Vassilakos P, Petignat P. Human papillomavirus self-sampling in Cameroon: Women’s uncertainties over the reliability of the method are barriers to acceptance. J Low Genit Tract Dis. 2013;17:235–41.CrossRefPubMed
34.
go back to reference Lazcano-Ponce E, Lorincz AT, Cruz-Valdez A, Salmerón J, Uribe P, Velasco-Mondragón E, Nevarez PH, Acosta RD, Hernández-Avila M. Self-collection of vaginal specimens for human papillomavirus testing in cervical cancer prevention (MARCH): a community-based randomised controlled trial. Lancet. 2011;378:1868–73.CrossRefPubMed Lazcano-Ponce E, Lorincz AT, Cruz-Valdez A, Salmerón J, Uribe P, Velasco-Mondragón E, Nevarez PH, Acosta RD, Hernández-Avila M. Self-collection of vaginal specimens for human papillomavirus testing in cervical cancer prevention (MARCH): a community-based randomised controlled trial. Lancet. 2011;378:1868–73.CrossRefPubMed
35.
go back to reference Anhang R, Nelson JA, Telerant R, Chiasson MA, Wright TC. Acceptability of self-collection of specimens for HPV DNA testing in an urban population. J Women's Health. 2005;14:721–8.CrossRef Anhang R, Nelson JA, Telerant R, Chiasson MA, Wright TC. Acceptability of self-collection of specimens for HPV DNA testing in an urban population. J Women's Health. 2005;14:721–8.CrossRef
36.
go back to reference Schmeink CE, Bekkers RLM, Massuger LFAG, Melchers WJG. The potential role of self-sampling for high-risk human papillomavirus detection in cervical cancer screening: role of self-sampling for hr-HPV detection. Rev Med Virol. 2011;21:139–53.CrossRefPubMed Schmeink CE, Bekkers RLM, Massuger LFAG, Melchers WJG. The potential role of self-sampling for high-risk human papillomavirus detection in cervical cancer screening: role of self-sampling for hr-HPV detection. Rev Med Virol. 2011;21:139–53.CrossRefPubMed
37.
go back to reference Petignat P, Vassilakos P. Is it time to introduce HPV self-sampling for primary cervical cancer screening? JNCI Journal of the National Cancer Institute. 2012;104:166–7.CrossRefPubMed Petignat P, Vassilakos P. Is it time to introduce HPV self-sampling for primary cervical cancer screening? JNCI Journal of the National Cancer Institute. 2012;104:166–7.CrossRefPubMed
38.
go back to reference Cuzick, J., Bergeron, C., von Knebel Doeberitz, M., Gravitt, P., Jeronimo, J., Lorincz, A. T., J.L.M. Meijer, C., Sankaranarayanan, R., J.F. Snijders, P. and Szarewski, A. (2012) New technologies and procedures for cervical cancer screening. Vaccine 30, F107–F116. Cuzick, J., Bergeron, C., von Knebel Doeberitz, M., Gravitt, P., Jeronimo, J., Lorincz, A. T., J.L.M. Meijer, C., Sankaranarayanan, R., J.F. Snijders, P. and Szarewski, A. (2012) New technologies and procedures for cervical cancer screening. Vaccine 30, F107–F116.
39.
go back to reference Mitchell S, Ogilvie G, Steinberg M, Sekikubo M, Biryabarema C, Money D. Assessing women’s willingness to collect their own cervical samples for HPV testing as part of the ASPIRE cervical cancer screening project in Uganda. Int J Gynecol Obstet. 2011;114:111–5.CrossRef Mitchell S, Ogilvie G, Steinberg M, Sekikubo M, Biryabarema C, Money D. Assessing women’s willingness to collect their own cervical samples for HPV testing as part of the ASPIRE cervical cancer screening project in Uganda. Int J Gynecol Obstet. 2011;114:111–5.CrossRef
Metadata
Title
A tailored within-community specimen collection strategy increased uptake of cervical cancer screening in a cross-sectional study in Ghana
Authors
Adolf K. Awua
Edwin K. Wiredu
Edwin A. Afari
Ahmad S. Tijani
Gabriel Djanmah
Richard M. K. Adanu
Publication date
01-12-2018
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2018
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-017-4631-y

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