Sustainable Development of Pathology in Sub-Saharan Africa: An Example From Ghana

Stalsberg, Helge; Adjei, Ernest; Owusu-Afriyie, Osei; Isaksen, Vidar

doi:10.5858/arpa.2016-0498-oa

Cited by 8 publications

(7 citation statements)

References 29 publications

(15 reference statements)

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“…On the basis of the findings described in this report and review of relevant literature, we recommend consideration of the following objectives: (1) organize pathology and oncology organizations to conduct ongoing audits of oncologic pathology and to guide continuing professional education programs on topics including pathology reporting, tissue handling and fixation, and relevance of pathology information to individual and population health; (2) share lessons learned and best practices regarding pathology capacity building with medical and public health organizations in neighboring countries; (3) promote use of evidence-based templates and checklists for pathology reporting in Ethiopia, which could be developed by selecting portions of the College of American Pathologists protocol corresponding to the BCI 2.3 basic and limited resource data elements; (4) promote use of electronic pathology reports to facilitate quality measurement; and (5) expand training in histotechnology (including IHC) and oncologic pathology and access to necessary equipment via collaboration with laboratories in high-resource regions, as described in published reports 32 - 35 (however, such programs require sufficient resource investment to support ongoing availability of basic cancer control services).…”

Section: Discussionmentioning

confidence: 99%

Adequacy of Pathologic Reports of Invasive Breast Cancer From Mastectomy Specimens at Tikur Anbessa Specialized Hospital Oncology Center in Ethiopia

Yesufe

Assefa

Bekele

et al. 2018

JGO

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PurposeAlthough information from pathology reports is essential to the care of individuals with cancer and to population-level cancer control, no systematic evidence exists regarding the adequacy of breast pathology reporting in Ethiopia. This study audited pathology reports of mastectomy specimens from patients evaluated at the Tikur Anbessa Specialized Hospital Oncology Center in Addis Ababa, Ethiopia.MethodsMastectomy pathology reports from February 2014 through January 2016 were assessed for gross and microscopic information considered by the Breast Cancer Initiative 2.5 (BCI 2.5; formerly the Breast Health Global Initiative) guideline to be necessary for care of patients with breast cancer stratified according to basic, limited, and enhanced resource settings.ResultsFewer than two thirds (61.6%) of the 417 reports we reviewed included all four of the BCI 2.5 basic pathology data elements we could evaluate with available data (tumor category, lymph node category, histologic type, and histologic grade). Only 1.0% of reports included all three pathology data elements recommended for limited resource settings (estrogen receptor status, margin status, and lymphovascular invasion). Several elements were significantly more likely to be noted in reports from nonpublic hospitals than from public hospitals. Although only three of 417 reports included checklists or templates, all three of these reports included all of the basic pathology information, and they all included at least two of the three limited pathology elements not already on the basic list.ConclusionMore than one third (38.4%) of mastectomy pathology reports did not meet BCI 2.5 standards for basic resource settings. Quality measurement and improvement programs and capacity-building interventions by national pathology and oncology organizations, collaboration with medical and public health organizations in neighboring countries, adoption of synoptic reporting templates, use of electronic pathology reporting, and histotechnology and histopathology training collaborations with laboratories in high-resource regions are recommended.

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Section: Discussionmentioning

confidence: 99%

Adequacy of Pathologic Reports of Invasive Breast Cancer From Mastectomy Specimens at Tikur Anbessa Specialized Hospital Oncology Center in Ethiopia

Yesufe

Assefa

Bekele

et al. 2018

JGO

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“…Good communication and connectivity between the referring clinic and the central laboratory is important . Central laboratories can also serve as hubs for training and research, as happened between Ghana and Norway …”

Section: Concurrent Support To Optimize the Use Of Cancer Medicinesmentioning

confidence: 99%

“…77 Central laboratories can also serve as hubs for training and research, as happened between Ghana and Norway. 105…”

Section: Oncology-related Laboratory Servicesmentioning

confidence: 99%

Enhancing global access to cancer medicines

Cortés

Peréz-García

Llombart-Cussac

et al. 2020

CA A Cancer J Clinicians

143

108

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Globally, cancer is the second leading cause of death, with numbers greatly exceeding those for human immunodeficiency virus/acquired immunodeficiency syndrome, tuberculosis, and malaria combined. Limited access to timely diagnosis, to affordable, effective treatment, and to high‐quality care are just some of the factors that lead to disparities in cancer survival between countries and within countries. In this article, the authors consider various factors that prevent access to cancer medicines (particularly access to essential cancer medicines). Even if an essential cancer medicine is included on a national medicines list, cost might preclude its use, it might be prescribed or used inappropriately, weak infrastructure might prevent it being accessed by those who could benefit, or quality might not be guaranteed. Potential strategies to address the access problems are discussed, including universal health coverage for essential cancer medicines, fairer methods for pricing cancer medicines, reducing development costs, optimizing regulation, and improving reliability in the global supply chain. Optimizing schedules for cancer therapy could reduce not only costs, but also adverse events, and improve access. More and better biomarkers are required to target patients who are most likely to benefit from cancer medicines. The optimum use of cancer medicines depends on the effective delivery of several services allied to oncology (including laboratory, imaging, surgery, and radiotherapy). Investment is necessary in all aspects of cancer care, from these supportive services to technologies, and the training of health care workers and other staff.

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“…Development of surgical pathology services is time consuming and requires significant investment in equipment and education as demonstrated by the decade-long effort to develop pathology services at a teaching hospital in Kumasi, Ghana. 44 Because of this, further development of centralised pathology services with an emphasis on streamlining send out services should be prioritised as Ghana continues the long-term investment of increasing the pathology workforce. The final step in breast cancer care, treatment, requires several medical specialties and treatment modalities.…”

Section: Open Accessmentioning

confidence: 99%

Surveying and mapping breast cancer services in Ghana: a cross-sectional pilot study in the Eastern Region

et al. 2021

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ObjectivesDefine the services available for the care of breast cancer at hospitals in the Eastern Region of Ghana, identify areas of the region with limited access to care through geospatial mapping, and test a novel survey instrument in anticipation of a nationwide scale up of the study.DesignA cross-sectional, facility-based survey study.SettingThis study was conducted at 33 of the 34 hospitals in the Eastern Region of Ghana from March 2020 to May 2020.ParticipantsThe 33 hospitals surveyed represented 97% of all hospitals in the region. This included private, government, quasi-government and faith-based organisation owned hospitals.ResultsSixteen hospitals (82%) surveyed provided basic screening services, 11 (33%) provided pathological diagnosis and 3 (9%) provided those services in addition to basic surgical care.53%, 64% and 78% of the population lived within 10 km, 25 km and 45 km of screening, diagnostic and treatment services respectively. Limited chemotherapy was available at two hospitals (6%), endocrine therapy at one hospital (3%) and radiotherapy was not available. Twenty-nine hospitals (88%) employed a general practitioner and 13 (39%) employed a surgeon. Oncology specialists, pathology personnel and a plastic surgeon were only available in one hospital (3%) in the Eastern Region.ConclusionsAlthough 16 hospitals (82%) provided screening, only half the population lived within reasonable distance of these services. Few hospitals offered diagnosis and surgical services, but 64% and 78% of the population lived within a reasonable distance of these hospitals. Geospatial analysis suggested two priorities to cost-effectively expand breast cancer services: (1) increase the number of health facilities providing screening services and (2) centralise basic imaging, pathological and surgical services at targeted hospitals.

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Sustainable Development of Pathology in Sub-Saharan Africa: An Example From Ghana

Cited by 8 publications

References 29 publications

Adequacy of Pathologic Reports of Invasive Breast Cancer From Mastectomy Specimens at Tikur Anbessa Specialized Hospital Oncology Center in Ethiopia

Adequacy of Pathologic Reports of Invasive Breast Cancer From Mastectomy Specimens at Tikur Anbessa Specialized Hospital Oncology Center in Ethiopia

Enhancing global access to cancer medicines

Surveying and mapping breast cancer services in Ghana: a cross-sectional pilot study in the Eastern Region

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