PURPOSE In East Africa, cervical cancer is a leading cause of morbidity and mortality among women diagnosed with cancer. In this study, we describe the burden of risk factors for cervical cancer among women of reproductive age in five East African countries. METHODS For each country, using STATA13 software and sampling weights, we analyzed the latest Demographic and Health Survey data sets conducted between 2014 and 2017 in Burundi, Kenya, Rwanda, Tanzania, and Uganda. We included women age 15-49 years and considered six risk factors (tobacco use, body mass index, age at first sexual intercourse, age at first birth, number of children, and hormonal contraceptive use). RESULTS Of the 93,616 women from the five countries, each country had more than half of the women younger than 30 years and lived in rural areas. Pooled proportion of women with at least one risk factor was 89% (95% CI, 87 to 91). Living in a rural area in Burundi (adjusted incidence rate ration 0.94; 95% CI, 0.9 to 0.99; P = .019) and Rwanda (adjusted incidence rate Ration 0.92; 95% CI, 0.88 to 0.96; P < .001) was associated with a lower number of risk factors compared with living in an urban area. In all the countries, women with complete secondary education were associated with a lower number of risk factors compared with those with no education. CONCLUSION This study reveals a high burden of risk factors for cervical cancer in East Africa, with a high proportion of women exposed to at least one risk factor. There is a need for interventions to reduce the exposure of women to these risk factors.

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Purpose: In East Africa, cervical cancer is a leading cause of morbidity and mortality amongst women diagnosed with cancer in East Africa. We aimed to describe the burden of risk factors for cervical cancer among women of reproductive age in five East African countries to inform the design of interventions to the reduce exposure of women to them. Methods: For each country, using STATA13 and sampling weights, we analysed Demographic and Health Survey (DHS) datasets conducted between 2014 and 2017 in Burundi, Kenya, Rwanda, Tanzania, and Uganda. The surveys followed a two-stage cluster random sampling procedure. We included women aged 15 to 49 years and considered six risk factors (tobacco use, body mass index, age at first sexual intercourse, age at first birth, number of children and hormonal contraceptive use). Poisson regression was used to determine the demographics associated with the number of risk factors a woman had. Results: From 93,616 women from the countries, each country had more than half younger than 30 years of age with majority living in rural areas. Pooled proportion of women with at least one risk factor was 89% (95% Confidence interval, CI 87% - 91%). Living in a rural area in Burundi (Adjusted Incidence Rate Ration, aIRR 0.94; 95% CI: 0.9–0.99; p = 0.019) and Rwanda [aIRR 0.92; 95% CI: 0.88 - 0.96; p &lt; 0.001] was associated with a lower number of risk factors among women compared with living in an urban area. In all the countries, women with complete secondary education were associated with the lowest number of risk factors for cervical cancer compared with those living in urban areas. Conclusion: Our study revealed a high burden of risk factors for cervical cancer in East Africa with a high proportion of women having at least one risk factor. Citation Format: Derrick Abila, Provia Ainembabazi, Sulaiman Wasukira, Henry Wabinga. Burden of Risk Factors for Cervical Cancer among Women Living In East Africa: Analysis of the Latest Demographic Health Surveys Conducted between 2014 And 2017 [abstract]. In: Proceedings of the 9th Annual Symposium on Global Cancer Research; Global Cancer Research and Control: Looking Back and Charting a Path Forward; 2021 Mar 10-11. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2021;30(7 Suppl):Abstract nr 113.

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Background The type of cooking fuel used in households can expose the members to polluted air which has been shown to have multiple health effects. We describe the trend in household air pollution (HAP) caused by the type of cooking fuel used in Ugandan households from 2001 to 2016 and explore the household factors associated with it. Methods This was a retrospective analysis of four datasets of Ugandan demographic and health surveys (DHS) conducted from 2000/2001 to 2016 with the household as the unit of analysis. We included variables that described the households, the type of cooking fuel, and where the food was cooked. A household was considered to have exposure to HAP if they used cooking fuels like coal, charcoal, wood, straw/shrubs/grass, crops, or animal dung for cooking. Bivariate and multivariate logistic regression was used to determine the association between household characteristics and exposure to household air pollution (HAP) from the most recent DHS of 2016. Results A total of 45,376 households were included in the study. In all the surveys, the majority of the households were rural (74.33–85.11%), were headed by a male (68.98–72.46%), and with their highest educational attainment as incomplete primary education (37.21–42.44%). In all the surveys, the majority of the households used wood as a cooking fuel (71.69–82.08%). Most of the households were exposed to HAP (96.69–99.80%). From the multivariate logistic regression analysis, households with a household head having attained either complete secondary education [Adjusted Odd ratio: 0.13, 95% Confidence interval (0.03–0.58), p-value = 0.008] or higher education [Adjusted Odd ratio: 0.11, 95% Confidence interval (0.03–0.48), p-value = 0.003] were less likely to be exposed to HAP when compared with households with a household head having no education. Conclusions This study revealed that most households in Uganda have exposure to household air pollution caused by the type of cooking fuel used in the household. This underscores the need for innovations in cooking fuels like clean energy stoves that are cost-effective and cause less exposure to household air pollution.

PURPOSE The World Health Organisation (WHO) launched the Global Breast Cancer Initiative (GBCI) in 2020 intending to reduce global breast cancer mortality by 2.5% per year until 2040, thereby averting an estimated 2.5 million deaths. In this study, we aimed to determine the coverage and socio-economic inequalities in the screening for breast cancer over one decade before the establishment of the GBCI. METHODS For each country, using STATA 16 software and sampling weights, we analyzed the datasets of Demographic and Health Surveys (DHS) that included questions on breast cancer screening and were conducted between 2010 and 2019 in low- and middle-income countries. We included women aged 15-49 years and considered screening using breast self-examination (BSE), clinical breast examination (CBE), and mammography. Absolute and relative inequalities were determined using the Slope Index of Inequality (SII) and Concentration Index (CIX) respectively. RESULTS A total of 18 surveys from 13 countries were included in this study. Only six surveys from five countries measured the rates of screening by mammography which ranged from 5.58% to 12.96%. Considering screening using any method, the proportion that had ever screened for breast cancer ranged from 2.53% to 60.21%. Higher rates of screening were seen in upper-middle-income countries compared to low-income countries. For the CIX for screening using any method, the inequalities were pro-rich in all the countries except the Philippines where it was pro-poor with a CIX of –2.84 ( P value .015). For the CIX and SII for screening using mammography, the inequalities were pro-rich in all the countries. CONCLUSION There exist socio-economic disparities in the coverage of breast cancer using mammography, clinical breast examination, and breast self-exam. There is a need to address these disparities to achieve the targets of breast cancer control by the GBCI.