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Item type:Publication, Ant Colony Optimization-Enabled CNN Deep Learning Technique for Accurate Detection of Cervical Cancer(Hindawi Limited, 2023-01-01)Cancer is characterized by abnormal cell growth and proliferation, which are both diagnostic indicators of the disease. When cancerous cells enter one organ, there is a risk that they may spread to adjacent tissues and eventually to other organs. Cancer of the cervix of the uterus often initially manifests itself in the uterine cervix, which is located at the very bottom of the uterus. Both the growth and death of cervical cells are characteristic features of this condition. False-negative results provide a significant moral dilemma since they may cause women to get an incorrect diagnosis of cancer, which in turn can result in the woman's premature death from the disease. False-positive results do not raise any significant ethical concerns; but they do require a patient to go through an expensive and time-consuming treatment process, and they also cause the patient to experience tension and anxiety that is not warranted. In order to detect cervical cancer in its earliest stages in women, a screening procedure known as a Pap test is often performed. This article describes a technique for improving images using Brightness Preserving Dynamic Fuzzy Histogram Equalization. To individual components and find the right area of interest, the fuzzy c-means approach is applied. The images are segmented using the fuzzy c-means method to find the right area of interest. The feature selection algorithm is the ACO algorithm. Following that, categorization is carried out utilizing the CNN, MLP, and ANN algorithms. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Political determinants of cervical cancer control in Peru(BioMed Central Ltd, 2025-12-01)BACKGROUND: Cervical cancer (CC) is the most common and second-most deadly cancer among Peruvian women, despite national authorities' sustained political and budgetary efforts to improve Human Papillomavirus (HPV) vaccination, screening for early detection of cervical cancer, and making treatment more accessible. Considering the importance of the health system in CC prevention and control, this article examines the role of the health system as a whole in the CC screening in Peru, a dimension that previous studies have not comprehensively covered. To this end, this article utilizes the WHO's building blocks framework as an analytical tool to examine the performance of the health system when providing services to prevent, detect, and treat CC. METHODS: The research took place in the region of Madre de Dios, located southeast of the Peruvian Amazon. Madre de Dios reports the second-highest CC mortality rate in the country, and a lack of oncologic treatment (chemotherapy, radiotherapy, pediatrics, and surgical) and palliative care units. This qualitative study is grounded in in-depth interviews with key informants in Lima and Madre de Dios, as well as an analysis of report records provided by health authorities in Madre de Dios and Lima. The interviews were conducted between November 2022 and August 2023. They are policy experts with experience in designing national-level health policies, as well as health officials in Madre de Dios. Additionally, they have conducted interviews with representatives of civil society organisations in Madre de Dios. Additionally, we analyzed the anonymized records of Pap smear results collected in Madre de Dios for the years 2020, 2021, and 2022. RESULTS: Governance is crucial for organizing CC activities. Vertical national programs and policies are failing to accommodate local solutions and lack sensitivity to the unique characteristics of different contexts. CC policies in Peru are ambitious, and their implementation is challenged in Madre de Dios by the lack of trained human resources at the primary healthcare and hospital level, lack of laboratories, lack of financial resources for patient referrals, poor information system that do not allow patient follow-up, and lack of resources and political will to guarantee equipment maintenance. The analysis also highlights the significant shortcomings of organizing health system indicators around services provided, thereby ignoring indicators that assess the impact of health interventions on population health. CONCLUSIONS: The analysis demonstrated the utility of the WHO health system building blocks framework in analyzing the shortcomings of public policies aimed at preventing, detecting, and treating CC. It also provides a comprehensive view of the critical features of the health system that must be considered when designing and implementing interventions to address health conditions, such as CC.4 - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Defining drivers of human papillomavirus (HPV) vaccine uptake in migrant populations globally and strategies and interventions to improve coverage: a systematic review(2025-02-02)Background The Cervical Cancer Elimination Initiative by the World Health Organization (WHO) has set a target of 90% human papillomavirus (HPV) vaccination coverage among girls by age 15 by 2030 to dramatically reduce deaths from cervical and other HPV-related cancers. However, progress has been slow, with only 27% global coverage in 2023. Migrants are considered an under-immunised group globally for many vaccine-preventable diseases, with data showing that they may experience a high burden of HPV infection and widespread HPV under-immunisation. Better understanding of the factors influencing the ability of these communities to get vaccinated for HPV is important. We aimed to systematically synthesise evidence on drivers of HPV vaccination uptake in migrants, and explored recommended approaches, strategies, and best practices to promote uptake in these communities. Methods We searched seven databases (e.g., Medline, Global Health) and websites (WHO, IOM, Google Scholar) for literature on drivers of HPV vaccination uptake among migrants globally, published between January 2006 and December 2024 in any language. Data on influencing factors for HPV vaccination uptake in migrants were extracted for an integrated approach to synthesising findings, and recommended strategies to improve it were compiled. We conducted a hybrid thematic analysis using the WHO BeSD model and assessed risk of bias with Joanna Briggs Institute checklists. PROSPERO protocol: CRD42023401694. Findings We identified 1,806 database records and 1,756 records from websites, ultimately including 117 studies with 5,638,836 participants across 16 countries and one territory (including 933,187 first- and second-generation migrants, mostly defined as foreign-born in high-income countries). Factors negatively influencing vaccine uptake included concerns about vaccine safety, cultural beliefs, uncertainty about HPV vaccines/infection, low knowledge of HPV/HPV vaccine, gender/sex, inter-generational and family dynamics, exposure to negative information, and lack of recommendations from healthcare providers. Practical barriers included limited information on services, language issues combined with a lack of skilled interpreters, logistical challenges, and the high cost of the vaccine. Enablers mainly included positive perceptions and trust in the vaccine and healthcare providers, realistic expectations from parents regarding the sexual activity of adolescents, a sense of responsibility, as well as recommendations from healthcare providers and support from social networks. Other positive predictors of vaccine uptake included being female, and having a history of vaccine-preventable diseases or abnormal Pap test results. Findings highlighted that free-of-charge and school-based schemes were effective in increasing uptake, while mandatory or optional schemes were less popular. Key recommended approaches included culturally sensitive messaging and tailored communication for different target groups (e.g., parents/caregivers, adolescents), with an emphasis on strength framing. Deploying trusted mediators (e.g., peer school health promoters, religious champions, community health workers) and implementing practical solutions to address missed opportunities (e.g., bundling HPV vaccination with other services) and for mobile migrants (e.g., eHealth) were also emphasised. Additionally, strong provider recommendations and reducing access barriers through measures including walk-in, mobile, and outreach services were recommended, alongside addressing broader cross-cutting issues, such as strengthening vaccine monitoring systems. Interpretation This review showed that migrants worldwide face complex individual, family/social, and provider/system-level barriers to HPV vaccination, resulting in missed opportunities for protection. In many low- and middle-income countries (LMICs), the vaccine is either unavailable or has to be paid for. Achieving global commitments for universal and equitable immunisation across the life-course, making progress toward cervical cancer elimination, requires addressing these barriers through multi-pronged strategies. This includes combining effective health communication to build trust and address negative perceptions, along with efforts to eliminate physical barriers to vaccine access. Given the lack of data from LMICs, future research must urgently explore specific drivers of HPV vaccination among migrants in these regions where they are more concentrated and access to the HPV vaccine is limited, as well as develop solutions to system-level problems. Collaborative efforts with migrant communities are essential to co-develop effective, tailored delivery models that meet their unique needs. Funding This research was funded by the NIHR (NIHR300072), the Academy of Medical Sciences (SBF005\1111), and the Medical Research Council (MRC/N013638/1).1