Self-Collection of Vaginal Swabs Among Adolescent Girls in a School-Setting in East Africa
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Date
2019
Journal Title
Journal ISSN
Volume Title
Publisher
Sexually transmitted diseases
Abstract
Few studies have evaluated the acceptability of self-collected
vaginal swabs among young women in sub-Saharan Africa, including in
school settings. We evaluated the acceptability of 2 conditions for the
self-collection of swabs in secondary schools in Entebbe, Uganda.
Methods: Assenting girlswith parental consent from3 secondary schools
were provided instructions for sampling, and randomly allocated to selfcollection
of vaginal swabs with or without nurse assistance to help with
correct placement of the swab. Swabs were tested for bacterial vaginosis by
Gram stain. Participants were followed up after 1 to 2 days and 1 to 2 weeks
and invited for a qualitative interview.
Results: Overall 96 girls were enrolled (median age, 16 years; interquartile
range, 15–17 years). At the first follow-up visit, participants in both
arms reported that instructions for sample collection were easy to understand,
and they felt comfortablewith self-collection.Girls in the nurse assistance
arm reported feeling less relaxed (27% vs. 50%, P = 0.02) than those
in the armwithout nurse assistance, but more confident that they collected the
sample correctly (96% vs. 83%, P = 0.04). About half (47%) of participants
agreed that self-sampling was painful, but almost all (94%) would participate
in a similar study again. Qualitative data showed that participants preferred
self-collection without nurse assistance to preserve privacy. Bacterial
vaginosis prevalence was 14% (95% confidence interval, 8–22).
Conclusions: In this setting, self-collection of vaginal swabs in secondary
schools was acceptable and feasible, and girls preferred self-collection without
nurse assistance. Self-collection of swabs is an important tool for the
detection, treatment and control of reproductive tract infections in girls
and young women.
Description
Keywords
Vaginal Swabs, Adolescent Girls, School-Setting, East Africa
Citation
Francis, S. C., Miiro, G., Nakuya, K., Rutakumwa, R., Nakiyingi-Miiro, J., Nabaggala, G., ... & Weiss, H. A. (2019). Self-collection of vaginal swabs among adolescent girls in a school-setting in East Africa. Sexually transmitted diseases, 46(5), 335-341. DOI: 10.1097/OLQ.0000000000000990