Head and neck surgical subspecialty training in Africa: Sustainable models to improve cancer care in developing countries

Fagan, Johannes J.; Zafereo, Mark; Aswani, Joyce; Netterville, James L.; Koch, Wayne M.

doi:10.1002/hed.24591

Cited by 27 publications

(30 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Although the World Health Organization has declared the implementation of hearing screening programs as an important global health priority, LMICs have struggled to assemble and organize resources . Most LMICs have a shortage of trained hearing healthcare specialists (audiologists and otolaryngologists) who are able to identify and treat children with hearing loss …”

Section: Introductionmentioning

confidence: 99%

Community health worker‐based hearing screening on a mobile platform: A scalable protocol piloted in Haiti

Jayawardena

Nassiri

Levy

et al. 2020

Laryngoscope Investig Oto

Self Cite

View full text Add to dashboard Cite

Objective: To establish the feasibility of a systematic, community health worker (CHW)-based hearing screening program that gathers Health Insurance Portability and Accountability Act-compliant electronic data (otoscopic images of tympanic membrane and audiometric evaluation) on a smartphone in an effort to streamline treatment options in resource-limited communities.Methods: This is a cross-sectional study in which four schools were screened in Portau-Prince, Haiti, during in April 2018. A total of 122 subjects (61% female) aged 5-17 years underwent an initial brief audiometric screen followed by a more comprehensive air conduction audiometric evaluation if they failed their initial screen. Participants with more than 35-dB loss in any frequency on their comprehensive audiometric evaluation received endoscopic otoscopy.Results: Seventy-five percent of subjects (91/122) passed their initial screen. Of those who failed, 9% (4/44 ears) had a severe or profound hearing loss on comprehensive evaluation. Abnormal otoscopic findings (11/36 ears, 31%) included are cerumen impaction (n = 6), myringosclerosis (n = 3), tympanic membrane perforation (n = 1), and tympanic membrane retraction (n = 1). The average duration of the initial testing was 100 seconds (SD = 74 seconds), whereas the duration of comprehensive testing was 394 seconds (SD = 175 seconds). Extrapolating from these data, we estimate that a group of seven trained CHWs could gather formal audiologic and otologic data points for 100 children per hour using this protocol.

show abstract

Section: Introductionmentioning

confidence: 99%

Community health worker‐based hearing screening on a mobile platform: A scalable protocol piloted in Haiti

Jayawardena

Nassiri

Levy

et al. 2020

Laryngoscope Investig Oto

Self Cite

View full text Add to dashboard Cite

show abstract

“…In developing countries, multiple factors other than poverty play a role in accessing HNC treatment. It is essential to create training programs and fellowships for physicians, nurses and other health and social care professionals both in their own countries and abroad to improve this situation [23]. In Europe, it is important to recognize that some HNC patient populations are highly vulnerable.…”

Section: Vulnerable Head and Neck Cancer Populationsocioeconomic Dispmentioning

confidence: 99%

European white paper: oropharyngeal dysphagia in head and neck cancer

Baijens

Walshe

Aaltonen

et al. 2020

Eur Arch Otorhinolaryngol

View full text Add to dashboard Cite

Purpose To develop a European White Paper document on oropharyngeal dysphagia (OD) in head and neck cancer (HNC). There are wide variations in the management of OD associated with HNC across Europe. Methods Experts in the management of specific aspects of OD in HNC across Europe were delegated by their professional medical and multidisciplinary societies to contribute to this document. Evidence is based on systematic reviews, consensus-based position statements, and expert opinion. Results Twenty-four sections on HNC-specific OD topics. Conclusion This European White Paper summarizes current best practice on management of OD in HNC, providing recommendations to support patients and health professionals. The body of literature and its level of evidence on diagnostics and treatment for OD in HNC remain poor. This is in the context of an expected increase in the prevalence of OD due to HNC in the near future. Contributing factors to increased prevalence include aging of our European population (including HNC patients) and an increase in human papillomavirus (HPV) related cancer, despite the introduction of HPV vaccination in various countries. We recommend timely implementation of OD screening in HNC patients while emphasizing the need for robust scientific research on the treatment of OD in HNC. Meanwhile, its management remains a challenge for European professional associations and policymakers.

show abstract

“…Only 24 of 52 African countries have radiotherapy facilities, and treatment delays may be up to 46 weeks. 4 Likewise, certain chemotherapy drugs and most targeted agents are not available to patients in these countries. Such diversity in management might invalidate the current favorable prognosis for advanced p16+ oropharyngeal cancer in the current staging in such resource-constrained settings.…”

Section: Commentarymentioning

confidence: 99%

Is AJCC/UICC Staging Still Appropriate for Head and Neck Cancers in Developing Countries?

et al. 2020

Self Cite

View full text Add to dashboard Cite

By 2030, 70% of cancers will occur in developing countries. Head and neck cancers are primarily a developing world disease. While anatomical location and the extent of cancers are central to defining prognosis and staging, the American Joint Committee on Cancer (AJCC)/International Union Against Cancer (UICC) have incorporated nonanatomic factors that correlate with prognosis into staging (eg, p16 status of oropharyngeal cancers). However, 16 of 17 head and neck surgeons from 13 African countries cannot routinely test for p16 status and hence can no longer apply AJCC/UICC staging to oropharyngeal cancer. While the AJCC/UICC should continue to refine staging that best reflects treatment outcomes and prognosis by incorporating new nonanatomical factors, they should also retain and refine anatomically based staging to serve the needs of clinicians and their patients in resource-constrained settings. Not to do so would diminish their global relevance and in so doing also disadvantage most of the world’s cancer patients.

show abstract

Head and neck surgical subspecialty training in Africa: Sustainable models to improve cancer care in developing countries

Abstract: Training can be achieved in a number of ways, which may be complimentary. Fellowship training is possible in developing countries. © 2016 Wiley Periodicals, Inc. Head Neck 39: 605-611, 2017.

Cited by 27 publications

References 12 publications

Community health worker‐based hearing screening on a mobile platform: A scalable protocol piloted in Haiti

Community health worker‐based hearing screening on a mobile platform: A scalable protocol piloted in Haiti

European white paper: oropharyngeal dysphagia in head and neck cancer

Is AJCC/UICC Staging Still Appropriate for Head and Neck Cancers in Developing Countries?

Contact Info

Product

Resources

About