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A group of students and professionals from the University of Navarra traveled to Kinshasa (Democratic Republic of Congo) to research a sustainable alternative to reduce the high mortality rate of cervical cancer in that country. Elikia, which means ‘hope’ in Lingala, is the name of the project on which the group, coordinated by Dr Luis Chiva, Professor of the School of Medicine and Director of the Department of Gynecology of the University of Navarra, have been working for 2 weeks.
It is not the first time that a group from this University has traveled to Kinshasa. In 2017 they made a first expedition to launch a cervical cancer screening program. In Congo, cervical cancer is the most prevalent cancer disease among women. There is no early detection system to reduce its incidence. Moreover, there is no human papillomavirus (HPV) vaccination program. Diagnosis in most patients is made when the tumor is at an advanced stage and usually results in the early death of the patient. In Congo, the incidence of cervical cancer is estimated at 30–35 per 100 000 inhabitants. The goal of the project is to achieve in 10 years a reduction to 4–6 per 100 000 in the area served by Monkole Hospital, the hospital hosting the study. They will try to implement a model of change in preventive health in the country based on a perspective of efficiency and solidarity.
Following OMS addresses, the Elikia study seeks to standardize a model of sustainable screening that should allow the ‘see and treat’ protocol. The group trained a group of local professionals to learn how to perform Visual Inspection with Acetic Acid (VIA) and detect suspicious lesions, which are immediately treated with thermal ablation, the model of treatment proposed by the World Health Organization for developing countries due to its easy feasibility. The objective of the study is also to assess the effectiveness of thermal ablation in decreasing the viral load of HPV in addition to removing the suspicious lesions.
During the 2-week period they screened a total of 1120 patients, all of whom underwent an HPV test, Pap smear, and also a biopsy for those with a positive VIA test result. All the tests have been returned to Europe and a team at the Universidad de Navarra is studying the results. The aim of the study is to validate thermal ablation as a sustainable and reliable method to eliminate both the lesions and HPV. In order to determine its effectiveness, they will perform a new Pap smear, HPV test, and biopsy in those patients with positive results in the first screening campaign after 3, 6, and 12 months.
Finally, the Elikia study seeks to raise the awareness of screening among Congolese women, to strengthen the creation of preventive models, and to promote the development of Monkole Hospital as a reference center for cancer prevention, diagnosis, and treatment in the country (Figures 1–3).
The international cervical cancer screening group just before starting the working day.
The whole local team after an educational session on cervical cancer screening.
Dr Chiva working in the operating room with his Congolese colleagues.
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Footnotes
Collaborators María Hitos, Iranzu Etchepare, Pilar Sánchez-Garcia, Claudia Sainz, Marta Larrañeta, Irene Martínez, Beatriz Fernández, Álvaro Chiva.
Contributors LC, MG-R and CT designed and wrote the article.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Provenance and peer review Not commissioned; internally peer reviewed.