Changes in the pattern of Kaposi’s sarcoma at Ocean Road Cancer Institute in Tanzania (2006–2011)

Koski, Lia; Ngoma, Twalib; Mwaiselage, Julius; Le, Lynne; Soliman, Amr S.

doi:10.1177/0956462414544724

Cited by 15 publications

(22 citation statements)

References 15 publications

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“…Unfortunately, unknown HIV status is a limitation that has been reported in previous studies and the results of this study should be taken with caution. 31,32 However, it is still important to report the results for this hospital-based study in order to further understand the HIV-positive cancer patients in this population and other similar underserved populations in developing countries.…”

Section: Discussionmentioning

confidence: 99%

Characteristics and geographic distribution of HIV-positive women diagnosed with cervical cancer in Dar es Salaam, Tanzania

et al. 2016

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Summary Background Cervical cancer is the leading incident cancer and the main cause of cancer-related mortality among women in sub-Saharan Africa. Furthermore, HIV-infected women are at a higher risk of developing cervical cancer than are HIV-negative women. The purpose of this study was to distinguish differences in characteristics of HIV-positive and HIV-negative patients with cervical cancer in Dar es Salaam, Tanzania. Methods The HIV status of cervical cancer patients diagnosed and/or treated at Ocean Road Cancer Institute in Dar es Salaam, Tanzania, during the period 2007–2011 was abstracted from the medical records. Additional abstracted information included patient’s name, age, place of residence, occupation, education, marital status, age at marriage, gravidity, and screening clinic visit results. Ocean Road Cancer Institute patients came from two sources, the screening clinic followed by treatment clinic or the treatment clinic without prior screening. HIV-positive and HIV-negative patients were compared regarding the above-listed clinical and epidemiologic factors. Multivariable analysis was also performed to assess the risk factors associated with cervical cancer treatment without prior screening at Ocean Road Cancer Institute. Results HIV-positive cervical cancer patients tended to be younger, with higher education, and lower parity. Patients screened for cervical cancer prior to treatment were more likely to be HIV-positive (OR: 2.09, 95% CI: 1.36, 3.21), less likely to have higher disease stages (OR: 0.64, 95% CI: 0.43, 0.94), and less likely to reside outside of Dar es Salaam (OR: 0.44, 95% CI: 0.30, 0.65). Conclusions Screening for cervical cancer at Ocean Road Cancer Institute is utilised by more HIV-positive patients from Dar es Salaam. Future studies should focus on identifying the reasons for lower utilisation of screening by HIV-negative patients and patients from other distant rural regions in Tanzania.

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Section: Discussionmentioning

confidence: 99%

Characteristics and geographic distribution of HIV-positive women diagnosed with cervical cancer in Dar es Salaam, Tanzania

et al. 2016

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“…Uldrick et al, reported post-HIV seroprevalence of KSHV as very common in sub-Saharan Africa, with seropositivity rates above 50%; moderately prevalent in Mediterranean countries (20–30%), but much less common (< 10%) in most of Europe, Asia and the US [7]. In Tanzania, the prevalence of AIDS-related KS was reported to be 2.4% at Bugando medical center in northwestern Tanzania from 2004 to 2014 [8], whereas Koski et al , reported prevalence of AIDS-associated KS to have dropped from 10.1% in 2003 to 7.4% in 2011 in a study conducted at Ocean Road Cancer Institute (ORCI), Tanzania [9]. A study conducted from 2006 to 2007 at The Kilimanjaro Christian Medical Centre (KCMC) Regional Dermatology Training Center (RDTC) and Mawenzi Regional Hospital Infectious Diseases Clinic in Moshi, northern Tanzania, reported a 4% prevalence of KS [10].…”

Section: Introductionmentioning

confidence: 99%

Prevalence and associated risk factors for Kaposi’s sarcoma among HIV-positive patients in a referral hospital in Northern Tanzania: a retrospective hospital-based study

et al. 2018

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BackgroundKaposi’s sarcoma (KS) is a multifocal angioproliferative tumor involving blood and lymphatic vessels, caused by Human Herpes Virus-8 (HHV-8). KS is an important AIDS-defining tumor with high prevalence in Sub-Saharan Africa, including Tanzania which has high HIV and HHV-8 sero-prevalence. It is critically important to monitor the prevalence of AIDS-defining tumors, such as KS, in the age of HIV/AIDS. We studied the prevalence of KS and associated risk factors among HIV-positive patients at Kilimanjaro Christian Medical Centre (KCMC), a referral hospital in northern Tanzania, over the period from January 2012 to December 2015.MethodsThis was a retrospective hospital-based cross-sectional study to determine the prevalence of KS among HIV/AIDS patients between 2012 and 2015. The study included 1100 HIV patients’ data which were collected at the Infectious Disease Clinic (IDC) from patients’ files. Stata version 13 (StataCorp LP, Texas 77,845 USA) was used for all statistical analyses. The prevalence of KS was calculated across levels of a number of categorical variables. Logistic regression was performed to determine relative risk of KS for all characteristics. We included all variables with p-values ≤10% in the multivariate analysis, including ART use, as this is considered to have an influence on KS. In the multivariate analysis, statistical significance was established based on a two-tailed p-value ≤5%. All patients’ notes were kept confidential as per the Helsinki declaration.ResultsOur results revealed a 4.6% prevalence of KS at KCMC hospital, between January 2012 and December 2015, 51(4.6%) patients were diagnosed with KS out of 1100 HIV-positive patients. The study further revealed that KS in HIV patients was most associated with low CD4 cell count (less than or equal to 200 cells/μl). Moreover, women were more likely than men to diagnosed with KS, with higher odds significantly associated with KS (OR 0.42, p < 0.009). Increased age, above 35 years, among the HIV seropositive patients was significantly associated with KS (OR 25.67, p < 0.007). HIV patients who were none smokers were more likely to suffer from KS compared to HIV smokers (OR 0.41, p < 0.010).ConclusionKS remains a common malignant vascular tumor commonly associated with HIV/AIDS in Tanzania. Our study highlights the need for continued efforts to combat HIV, as well as associated diseases such as KS. Continued availability of ART (Anti-Retroviral Therapy) to HIV/AIDS patients, and test reagents for CD4 cell count and viral load determination are important measures to alleviate the suffering of these patients. Furthermore, studies to gather more evidence on ART resistance are highly needed to guide treatment choices.

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“…Cervical, prostate, breast, Kaposi sarcoma, and esophageal cancers are among the most common types of malignancies in Tanzania [24]. While cervical, prostate, and breast cancers account for large proportions of the cancer burden in this population, the proportion of Kaposi sarcoma, an AIDS-defining malignancy, to all other cancers diagnosed is decreasing [24, 25]. Although NADCs evaluated in this study decreased in percentage over the 12-year period, ongoing evolution of risk factors and population characteristics in Tanzania may lead to increasing proportions of these types of malignancies in the future.…”

Section: Discussionmentioning

confidence: 99%

“…This study of NADCs in patients presenting to ORCI has multiple strengths. This study builds upon work previously done in this population to analyze changing patterns of Kaposi’s sarcoma as well as work on three other NADCs in order to more broadly characterize changing cancer burden in Tanzania and contribute to knowledge for future research in this population [11, 25]. This large dataset of patients with lung, liver, and head and neck cancers contains cases that were pathologically confirmed and included individuals from a majority of Tanzania’s geographic regions.…”

Section: Discussionmentioning

confidence: 99%

Changing Patterns of lung, liver, and head and neck non-AIDS-defining cancers relative to HIV status in Tanzania between 2002-2014

Campbell

Soliman

Kahesa

et al. 2016

Infect Agents Cancer

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BackgroundTanzania, like other low-income countries, has an increasing cancer burden that remains underestimated. Infection-associated malignancies, particularly HIV-infection, represent a great proportion of cancer burden in Tanzania and throughout Africa. Availability of HIV treatment and improved survival of HIV patients are suggested factors related to increasing prevalence of non-AIDS-defining cancers (NADCs). This study examined patterns of NADCs and proportions of HIV-positivity at the Ocean Road Cancer Institute (ORCI).MethodsWe reviewed logbooks of all ORCI patients diagnosed and/or treated for lung, liver, and head and neck cancers during 2002–2014. The number of total cancers diagnosed at ORCI during this period was used to calculate proportions of NADCs. We abstracted medical records to obtain demographic and clinical profiles and HIV status information for 1127 patients diagnosed or treated during 2010–2014. Trends in numbers and proportions of NADCs were analyzed using Joinpoint regression. Characteristics of NADC patients were analyzed using multinomial logistic regression.ResultsNADCs diagnosed at ORCI increased by 33.8% from 2002 to 2014 while the proportion of NADCs relative to all cancers significantly decreased from 6.8% in 2002 to 5.6% in 2014 (APC = -2.74%). Numbers and proportions of lung and liver cancers increased compared to all cancer diagnoses from 2002 to 2014. The number of head and neck cancers increased while decreasing proportionally compared to all cancer diagnoses from 2002 to 2014. Among patients with pathologically confirmed NADCs between 2010 and 2014, HIV prevalence showed a non-statistically significant decrease from 8.1 to 7.1% (APC = -3.77%).ConclusionsAbsolute numbers of lung, liver, and head and neck cancers increased at ORCI by 1/3 since 2002. Improving survivorship of HIV patients and varying immunodeficiency status may have contributed to the increasing number of NADCs. Total cancer diagnoses nearly doubled during this period, leading to a smaller relative proportion of NADCs diagnosed in 2014 compared to 2002. Late- stage diagnosis and short survival of NADCs included this study may explain possible underestimation and smaller increase in proportion of these particular NADCs compared to other NADCs studied in Tanzania. The slight decrease in proportion of HIV-positive NADC patients during 2010–2014 may suggest increasing patient longevity and more effective HIV management in Tanzania.

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Changes in the pattern of Kaposi’s sarcoma at Ocean Road Cancer Institute in Tanzania (2006–2011)

Cited by 15 publications

References 15 publications

Characteristics and geographic distribution of HIV-positive women diagnosed with cervical cancer in Dar es Salaam, Tanzania

Characteristics and geographic distribution of HIV-positive women diagnosed with cervical cancer in Dar es Salaam, Tanzania

Prevalence and associated risk factors for Kaposi’s sarcoma among HIV-positive patients in a referral hospital in Northern Tanzania: a retrospective hospital-based study

Changing Patterns of lung, liver, and head and neck non-AIDS-defining cancers relative to HIV status in Tanzania between 2002-2014

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