Browsing by Author "Mejia Chicaiza, Jorge Victoriano"

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Conocimiento actitudes y prácticas sobre el aborto voluntario y terapéutico en especialistas en Ginecología y Obstetricia que laboran en Hospitales Públicos del cantón Cuenca
(2016) Ñauta Baculima, Manuel Jaime; Borja Robalino, Brigith Vanessa; Borja Robalino, Ricardo Stalin; Sacoto Coello, Maritza Catalina de la nube; Abril Matute, Cumanda Patricia; Llerena Cortez, Norma Edith; Mejia Chicaiza, Jorge Victoriano; Vega Crespo, Bernardo José
The penal integral code says that induced abortion is not punishable when it is performed to avoid a hazard on the women health and when the pregnancy is a consequence of a rape to a woman who suffers mental disabilities. OBJECTIVE: This research objective is to identify the knowledge, attitudes and practices of gynecologists from public hospitals in Cuenca on voluntary and therapeutic abortion; also it aims to identify the correlation between: age, gender, and years of practice and religious conceptions of gynecologists about the knowledge of the legislation on abortion and openness to the voluntary and therapeutic abortion. METHODOLOGY: A total of 27 gynecologists who work in public hospitals in Cuenca were surveyed; professionals who are working in centers with internship were selected because they may have a higher contact with patients that require therapeutic abortions, or have seen patients with induced abortions. RESULTS: The sample was composed of 27 specialists in gynecology and obstetrics, with an average age of 37 years, the 77.8% male and 22.2% female; the average time of professional practice was 7.36; the 91.7% of professionals profess a religion, the 88.9% consider the religion how something important in their life. The 81.5% of respondents know that therapeutic abortion is legal in Ecuador; however, the 29.6% can quote correctly the grounds on which abortion is not punishable. The 63% of participants believe that abortion should be decriminalized in Ecuador in all grounds. The 22.2% (n = 6) of the professionals surveyed have made a therapeutic abortion; the 81% of respondents, has seen a patient with an induced abortion during the last year. In this research the association between age, gender, years of practice and religious conceptions of gynecologists, knowledge of legislation about abortion and its opening on voluntary and therapeutic abortion could not be proven. CONCLUSIONS: The knowledge about the grounds on which abortion is not punishable, it is low among gynecologists of public health services; a small percentage of them have experience in performing a therapeutic abortion, however, the 63% have a positive attitude towards the decriminalization of abortion in all its grounds.
Evaluation of urine and vaginal self-sampling versus clinician-based sampling for cervical cancer screening: a field comparison of the acceptability of three sampling tests in a rural community of Cuenca, Ecuador
(2022) Vega Crespo, Bernardo José; Neira Molina, Vivian Alejandra; Ortiz Segarra, José Ignacio; Gómez, Andrea; Vicuña, María José; Mejia Chicaiza, Jorge Victoriano
Self-sampling methods for HPV testing have been demonstrated to be highly sensitive and specific. The implementation of these methods in settings with a lack of infrastructure or medical attention has been shown to increase the coverage of cervical cancer screening and detect cervical abnormalities in the early stages. The aim of this study is to compare the acceptability of urine and vaginal self-sampling methods versus clinician sampling among rural women. A total of 120 women participated. Each participant self-collected urine and vaginal samples and underwent clinician sampling for Pap smear and HPV testing. After the sample collection, a questionnaire to qualify the device, technique, and individual acceptability was applied, and the additional overall preference of three sample tests was evaluated. Results: The characteristics of the participants were as follows: median age of 35 years; 40.8% were married; 46.7% had a primary level of education; median age of sexual onset of 17.6 years. Compared with clinician sampling, both vaginal self-sampling, OR 20.12 (7.67–52.8), and urine sampling, OR 16.63 (6.79–40.72), were more comfortable; granted more privacy: vaginal self-sampling, OR 8.07 (3.44–18.93), and urine sampling, OR 19.5 (5.83–65.21); were less painful: vaginal self-sampling, OR 0.07 (0.03–0.16), and urine sampling, OR 0.01 (0–0.06); were less difficult to apply: vaginal self-sampling, OR 0.16 (0.07–0.34), and urine sampling, OR 0.05 (0.01–0.17). The overall preference has shown an advantage for vaginal self-sampling, OR 4.97 (2.71–9.12). No statistically significant preference was demonstrated with urine self-sampling versus clinician sampling. Conclusions: Self-sampling methods have a high acceptance in rural communities. Doubts on the reliability of self-sampling often appear to be a limitation on its acceptability. However, the training and education of the community could increase the uptake of these methods.
Perceptions of Ecuadorian indigenous healers on their relationship with the formal health care system: barriers and opportunities
(2021) Bautista Valarezo, Estefanía; Duque, Víctor; Verhoeven, Veronique; Mejia Chicaiza, Jorge Victoriano; Hendrickx, Kristin; Maldonado Rengel, Ruth Elizabeth; Michels, Nele RM
The new paradigm of intercultural policies focuses on rethinking the common public culture. In Ecuador, the “Buen Vivir” plan seeks to incorporate the ancestral medical knowledge, experience and beliefs of traditional healers into the formal health services. This study explores views on the formal health system from the perspective of the healers belonging to the Kichwa and Shuar ethnicities in the South of Ecuador.
Role of self-sampling for cervical cancer screening: diagnostic test properties of three tests for the diagnosis of HPV in rural communities of Cuenca, Ecuador
(2022) Vega Crespo, Bernardo José; Neira Molina, Vivian Alejandra; Ortiz Segarra, José Ignacio; Orellana Huayllasaca, Maria Paz; Gómez, Andrea; Vicuña Luna, Maria Jose; Mejia Chicaiza, Jorge Victoriano
Background: HPV primary screening has shown effectiveness for cancer prevention; however, gynaecological examination is considered uncomfortable. Self-sampling methods increase the acceptance of screening. The aim of this study is to compare the sensitivity and specificity of clinician sampling versus vaginal and urine self-sampling for HPV diagnosis. Methods: A diagnostic test study was conducted in a rural parish of Cuenca, Ecuador. A total of 120 women participated. Each participant self-collected urine and vaginal samples and underwent clinician sampling for HPV testing. The latter was considered as the golden standard. All three samples were processed with the same amplification and hybridization protocol for HPV detection (Hybribio) following the manufacturer’s instructions. Results: Characteristics of the participants were: median age 35 years; 40.8% married; 46.7% had a primary level of education; and median age of sexual onset, 17.6 years. The prevalence of any type of HPV with clinician sampling was 15.0%, 17.5% with urine sampling and 18.3% with vaginal self-sampling. Self-sampling sensitivity reached 94.4% (IC 74.2–99.9), and specificity 92.1% (IC 85.2–95.9). Urine sampling had a sensitivity of 88.8% (IC 67.2, 96.9), and specificity 94.1% (IC 67.2–96.9). The negative predictive value was 98.9% (IC 94.2–99.8) for vaginal self-sampling and 97.6% (IC 92.6–99.4) for urine sampling. Conclusions: This study shows that vaginal and urine self-sampling methods have similar sensitivity and specificity compared with clinician sampling for the diagnosis of HPV. The correlation between HPV genotypes among the three tests is satisfactory.