Acta Scientific Gastrointestinal Disorders (ASGIS)(ISSN: 2582-1091)

Research Article Volume 6 Issue 2

Narrative Comparison Analysis of Colorectal Cancer Knowledge, Attitudes, and Practices of Health Care Workers in South Africa and Brazil

S Magwaza1*, G Van Hal1 and M Hoque2

1Social Epidemiology and Health Policy, University of Antwerp, Belgium

2Management College of Southern Africa, Durban, South Africa

*Corresponding Author: S Magwaza, Social Epidemiology and Health Policy, University of Antwerp, Belgium.

Received: December 09, 2022; Published: January 19, 2023


Aim: To conduct a narrative comparison of knowledge, attitudes, practices (KAP) and associated factors related to colorectal cancer (CRC) screening among health care workers (HCWs) working in South Africa (SA) and Brazil (BR).

Method: We conducted a KAP in South Africa in 2021 (noy yet published)and compared the results to a similar study conducted in Brazil which was identified through literature search of using multiple search engines and met the inclusion criteria (similar objectives, both used cross-sectional study designs, conducted the survey in public health settings, conducted in prior to implementation of CRC national screening programmes, conducted in country that is part of BRICS partnership, focused on KAP of health care workers, focused on CRC ,similar questions included in their data collection tools,). The comparative study was published in 2015. The South African (SA) study was conducted in 21 public health primary health care facilities in the city of Durban located in KwaZulu-Natal province (one of 9 provinces) in South Africa. Whereas the study from Brazil, randomly selected Health units (n = 1 600) across 26 states and the Federal District. There were 109 health care workers that responded to the survey in South Africa and a total of 1 251 that responded to the survey in Brazil. The study data was analysed using SPSS version 28 and SAS v.9.3 for South Africa and Brazil respectively. The narrative comparison used the STROBE checklist and captured data using Microsoft Excel to highlight the comparisons between the two studies.

Results: There were similarities in terms of study design, setting, target population, subject matter, question used for data collection and data analysis. Differences were observed in terms of year of data collection, the data collection methods, study sampling methods, study size and geographic coverage, study. In South Africa, self-administered survey was used while in Brazil, telephonic interviews were conducted. All participants in the facilities were invited to participate in the South African study, whereas, in Brazil, only those that were randomly selected were invited to participate. Random sampling used in BR compared to purposive sampling in SA, with the sample size much smaller than in Brazil. None of participants mentioned outreach CRC screening in SA, and only eleven of the participants reported to have ever conducted CRC screening. Whereas, in BR, four hundred (25%) units conducted outreach CRC screening. Eighty-three (47%) of doctors and 244 (65%) of nurses reported not conducting CRC screening. The South African study setting only included one city (11% coverage), whereas the Brazilian study was conducted in all states and Federation districts (100% coverage).

The results reported from both studies showed that there were differences in knowledge, attitudes and practices of medical doctors and nurses in both countries. The South African study showed that HCWs were less knowledgeable about CRC screening, types of screening tests, and had perceived these tests as less effective than the HCWs in the Brazilian study. The results of both studies had shown statistically significant associations between perceived influence of guidelines and outreach screening services provision. There was also a significant association between perceived influence of guidelines and the screening tests. The CRC screening practice, in SA study, was associated with previous training; working at least 40 hour a week, familiarity with different types of screening tests and perceived influence of NCCF and test to be effective. Whereas, in the Brazilian study screening was associated with gender, age, number of patients seen, clinical experience, start age of routine screening, familiarity of and perceived effectiveness of CRC screening tests. CRC screening in SA study only had significant association with a 40 hour working week, while in the BR study CRC screening has significant association with younger age, more than 5 years clinical experience, working 40 hours per week, solid familiarity with gFBOT and perception of gFBOT as very effective.

Conclusion: The narrative comparison review of the two studies from both countries highlights poor knowledge, attitudes and practices related to CRC screening. This is the first study to compare the KAP study results among HCWs from the two developing countries. It also highlights the importance of raising awareness of CRC burden, policy development, training and health systems preparedness is critical to enable access, uptake and shift health care worker attitudes and practice towards CRC screening.


Keywords: Colorectal Cancer; Cancer Screening; South Africa; Knowledge; Attitude; Practices; Brazil


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Citation: S Magwaza., et al. “Narrative Comparison Analysis of Colorectal Cancer Knowledge, Attitudes, and Practices of Health Care Workers in South Africa and Brazil". Acta Scientific Gastrointestinal Disorders 6.2 (2023): 03-15.


Copyright: © 2022 S Magwaza., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


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