Screening and risk factors for cervical cancer among survivors of sexual violence in conflict settings, Eastern Democratic Republic of Congo

Glorieux B. Kimoni(1), Ravonna Martin(2), Denis M. Mukwege(3), Cathleen de Kerchove(4), Sifa Naweza Ntamwenge(5), Olivier N. Ngeleza(6),


(1) The Ida Lee Project, Hôpital général de référence de Makiso, Kisangani, RD Congo; The Ida Lee Project, Hot Springs, Arkansas, United States of América
(2)  The Ida Lee Project, Hot Springs, Arkansas, United States of América
(3) Fondation Panzi, Bukavu, RD Congo; Département de gynécologie-obstétrique, Hôpital général de référence de Panzi, Bukavu, RD Congo
(4) Association The Children of Panzi and Elsewhere, Liège, Belgique
(5) Fondation Panzi, Bukavu, RD Congo; Association The Children of Panzi and Elsewhere, Liège, Belgique
(6) Département de gynécologie-obstétrique, Hôpital général de référence de Panzi, Bukavu, RD Congo
Corresponding Author

Abstract


This study assesses the risk that rape survivors have of developing cervical cancer in the context of conflict. A cross-sectional and descriptive study conducted in Bunyakiri and Kavumu, a conflict region in the east of the Democratic Republic of the Congo during the period from September 1 to 10, 2022, including 47 women survivors of sexual violence, 41 of whom were selected on the basis of certain criteria with age ranging from 18 to 50 years. Speculum examination was performed with visual inspection with acetic acid (VIA). After collecting data, the latter were encoded in the Excel file and grouped in the form of tables then analyzed after calculating the percentage. Ages of 21-30 years was the most represented, i.e., 56%. Among them, 34.1% were married and 31.7% were abandoned. Majority was in secondary school (46.3%) and illiterates (34.1%). 36.5% complained of pelvic pain and 36.5% reported first sexual intercourse at the age range of 13-15 years, of which 25 cases, i.e., 61% were sexually active. 39% reported having had 3 sexual partners in their life. VIA was negative in 97.5% of cases. It should be mentioned in this study that the environment of conflict zone, the circumstances of rape and the risky sexual behavior of survivors are an ecosystem that predisposes them to cervical cancer. (Afr J Reprod Health 2023; 27 [12]: 79-85).

References


Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram

I, Jemal A and Bray F. Global cancer statistics 2020:

GLOBOCAN estimates of incidence and mortality

worldwide for 36 cancers in 185 countries. CA Cancer

J Clin. 2021:71:209–49. doi:10.3322/caac.21660

Organisation Mondial de la santé (OMS). Cancer du col de

l’utérus.2022. Available from:

https://www.who.int/fr/news-room/factsheets/detail/cervical-cancer. Accessed Nov 30,2022

OMS. Lignes directrices de l’OMS pour le dépistage et le

traitement des lésions précancéreuses pour la

prévention du cancer du col de l’utérus.2014.

Available From:

https://apps.who.int/iris/handle/10665/112555.

Accessed Dec 20, 2022

Coker AL, Hopenhayn C, De Simone CP, Bush HM and

Crofford L. Violence against Women Raises Risk of

Cervical Cancer. J Women’s Heal. 2009; 18(8):1179–

Rubuye Mer S and Flicourt N. Femmes victimes des violences

sexuelles dans les conflits armés en République

Démocratique du Congo. Sexologies, 2015; 24 (3)

:114-121

Rouhani SA, Scott J, Greiner A, Albutt K, Hacker RM,

Kuwert P, VanRooyen M and Bartels S. Stigma and

Parenting Children Conceived from Sexual Violence.

Pediatrics. 2015;136(5):1195-1203

Hélène Sergent. Violences sexuelles: «Certaines maladies,

comme les fibromes et l'endométriose, sont surreprésentées chez les victimes». Interview, 2019.

Available from:

https://www.20minutes.fr/societe/2411867-

-violences-sexuelles-certaines-maladiescomme-fibromes-endometriose-surrepresenteeschez-victimes. Accessed Nov 30,2022

Organisation mondiale de la Santé (OMS), Fonds des Nations

Unies pour la population (FNUAP), le HautCommissariat des Nations Unies pour les réfugiés

(HCNUR). Prise en charge clinique des survivantes de

viol et de violence exercée par un partenaire intime :

élaboration de protocoles à adopter dans les situations

de crise humanitaire. Genève, OMS, 2022. Available

from https://apps.who.int/iris/?locale-attribute=fr&.

Accessed Nov 3, 2022

Panzi Foundation RDC. Verdict en appel du procès de viol

d’enfants à Kavumu : la bande à Batumike purgera bel

et bien sa peine. Fondation Panzi RDC, 2018.

Available From https://fondationpanzirdc.org/verdictappel-proces-de-viol-denfants-a-kavumu-bande-abatumike-purgera-bel-bien-peine/ . Accessed Oct 7,

Sud-Kivu : Début du procès de 2 Maï-Maï poursuivis pour

viol et meurtre à Bunyakiri. 7sur7. 2020. Available

From https://7sur7.cd/2020/09/29/sud-kivu-debut-duproces-de-2-mai-mai-poursuivis-pour-viol-etmeurtre-bunyakiri . Accessed Dec 2, 2022

Mapping Report. Rapport du projet Mapping sur les

violations des droits de l’homme et droit international

commise entre 1993 et 2003 en république

démocratique du Congo. Available from:

http://www.mapping-report.org/fr/actes-de-violencecontre-les-femmes-et-violences-sexuelles-vers-latransition-sud-kivu/. Accessed Dec 2, 2022

Sankaranarayanan R, Wesley R, Thara S,Dhakad N,

Chandralekha B, Sebastian P, Chithrathara K, Parkin

DM and Nair MK. Test characteristics of visual

inspection with 4% acetic acid (VIA) and Lugol's

iodine (VILI) in cervical cancer screening in Kerala,

India. Int J Cancer. 2003; 106 (3):404-408

Anorlu RI, Ola ER and Abudu OO. Low-cost methods for

secondary prevention of cervical cancer in developing

countries. Niger Postgrad Med J. 2007; 14 (14):242-

Edith M, Mahine I, Koumakpayi IH, Engohan-Aloghe C,

Ankély JC, Belembaogo E and Meye JF. Intérêt de

l’inspection visuelle à l’acide acétique et au soluté de

Lugol avec colposcope dans le dépistage des lésions

du col utérin au Gabon. Pan African Medical Journal.

; 22 :165.

Goldie S, Gaffikin L, Goldhaber-Fiebert J, Gordillo-Tobar

A, Levin C, Mahe C, Wright CT and Alliance for

Cervical Cancer Prevention Cost Working Group.

Cost effectiveness of cervical screening in five

developing countries. N Engl J Med .2005; 353

(20):2158- 2168

Brown MJ., Thacker LR. and Cohen SA. 2013. Association

between adverse childhood experiences and diagnosis

of cancer. PLOS One., 8: e-65524

Nyakio O, Kibukila F, Deschryver C, Bwami J, Kafilongo

V, Mukwege D, Tambwe A, Kakudji P, Kalenga P and

Kakoma JB. The perception of women victims of

sexual violence against cervical cancer screening.

International journal of current research. 2019 ; 11

(09) : 6950-6953

Bartels SA,Scott JA, Mukwege D, Lipton RI, VanRooyen M

and Learning J. Patterns of sexual violence in Eastern

Democratic Republic of Congo: reports from

survivors presenting to Panzi Hospital in 2006

Conflict and Health 2010, 4:9

Société Canadienne du cancer. Facteurs de risqué du cancer

du col de l’utérus.2022. From:

https://cancer.ca/fr/cancer-information/cancertypes/cervical/risks. Accessed Dec 24, 2022

Médecins Sans Frontières: The crushing burden of rape -

sexual violence in Darfur. 2005. From:

https://www.msf.org/crushing-burden-rape-sexualviolence-darfur. Accessed Dec 20, 2022

Schiffman M, Castle PE, Jeronimo J, Rodriguez AC and

Wacholder S. Human papillomavirus and cervical

cancer. Lancet. 2007; 370:890–907;

Bosch FX and de Sanjose ́ S. The epidemiology of human

papillomavirus infection and cervical cancer. Dis

Markers.2007; 23:213–227.


Full Text: PDF

Article Metrics

Abstract View : 713 times
PDF Download : 293 times

Refbacks

  • There are currently no refbacks.