title: Women's knowledge and attitudes towards cervical cancer prevention: a cross sectional study in Eastern Uganda.
abstract: Cervical cancer is a leading cause of morbidity and mortality among women in Uganda, often due to late disease diagnosis. Early screening for the cancer has been shown to be the most effective measure against the disease. Studies conducted elsewhere have reported the lack of awareness and negative attitudes towards cervical cancer as barriers to early screening. This study assessed the knowledge and attitudes of Ugandan women about cervical cancer prevention with the aim of informing prevention and control interventions.
  
  
  
  This study was conducted in Bugiri and Mayuge districts in eastern Uganda. It was a cross-sectional community based survey and collected data by means of a questionnaire. A total of 900 women aged 25-49 years participated in the study. Women's knowledge and attitudes towards cervical cancer prevention were assessed and scored. Data were analysed using STATA 12.0 software. Bivariate and multivariate analyses were carried out to establish the relationship between knowledge levels and demographic characteristics.
  
  
  
  Most (794; 88.2%) of the respondents had heard about cervical cancer, the majority (557; 70.2%) having received information from radio and 120 (15.1%) from health facilities. Most women (562; 62.4%) knew at least one preventive measure and (743; 82.6%) at least one symptom or sign of the disease. The majority (684; 76.0%) of respondents perceived themselves to be at risk of cervical cancer, a disease most (852; 94.6%) thought to be very severe. Living in peri-urban areas (AOR = 1.62, 95% CI: 1.15 - 2.28), urban areas (AOR = 3.64, 95% CI: 2.14 - 6.19), having a higher monthly income (AOR = 0.50, 95% CI: 0.37 - 0.68) and having had an HIV test (AOR = 1.99, 95% CI: 1.34-2.96) were associated with level of knowledge about cervical cancer prevention.
  
  
  
  Although general knowledge about cervical cancer prevention was relatively high among women, and attitudes mostly encouraging, specific knowledge about screening was low. There were also undesirable perceptions and beliefs regarding cervical cancer among respondents. There is therefore need for more education campaigns to bridge identified knowledge gaps, and scale up of cervical cancer screening services to all women to increase service uptake.
authors.affiliation: Department of Disease Control and Environmental Health, School of Public Health, College of Health Sciences, Makerere University, P.O Box 7072, Kampala, Uganda.
authors.forename: Trasias
authors.initials: T
authors.lastname: Mukama
authors.affiliation: Department of Disease Control and Environmental Health, School of Public Health, College of Health Sciences, Makerere University, P.O Box 7072, Kampala, Uganda. rndejjo@musph.ac.ug.
authors.forename: Rawlance
authors.identifier: 0000-0001-9263-557X
authors.initials: R
authors.lastname: Ndejjo
authors.affiliation: Department of Community Health, School of Public Health, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda.
authors.forename: Angele
authors.initials: A
authors.lastname: Musabyimana
authors.affiliation: Department of Disease Control and Environmental Health, School of Public Health, College of Health Sciences, Makerere University, P.O Box 7072, Kampala, Uganda.
authors.forename: Abdullah Ali
authors.initials: AA
authors.lastname: Halage
authors.affiliation: Department of Disease Control and Environmental Health, School of Public Health, College of Health Sciences, Makerere University, P.O Box 7072, Kampala, Uganda.
authors.forename: David
authors.initials: D
authors.lastname: Musoke
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D006266:Health Education / Q000379:methods / Q000592:standards / Q000706:statistics & numerical data; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D017589:Immunization Programs / Q000706:statistics & numerical data; D057226:Information Seeking Behavior; D008403:Mass Screening / Q000592:standards / Q000706:statistics & numerical data; D008875:Middle Aged; D010465:Perception; D011594:Psychometrics / Q000295:instrumentation; D012307:Risk Factors; D012424:Rural Population / Q000706:statistics & numerical data; D012749:Sexually Transmitted Diseases / Q000523:psychology; D011795:Surveys and Questionnaires; D014454:Uganda; D002583:Uterine Cervical Neoplasms / Q000517:prevention & control* / Q000523:psychology; D016387:Women's Health / Q000592:standards / Q000706:statistics & numerical data
keywords: Attitudes; Cervical cancer; Knowledge; Prevention; Rural; Screening; Uganda