Strengthening diagnostic capacity in Africa as a key pillar of public health and pandemic preparedness

Mfuh, Kenji O.; Abanda, Ngu Njei; Titanji, Boghuma K

doi:10.1371/journal.pgph.0001998

Cited by 9 publications

(3 citation statements)

References 15 publications

(16 reference statements)

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“…This may decrease the effectiveness and safety of the treatment, leaving more patients at risk for unnecessary autoimmune side effects. While there are additional biomarkers we did not assess in this survey, this finding likely reflects the dearth of trained pathologists and molecular testing facilities within SSA ( 5 , 35 , 36 ). Widespread availability of tumor biomarker testing may be a prerequisite for increased utilization of immunotherapy in SSA.…”

Section: Discussionmentioning

confidence: 99%

Utilization of cancer immunotherapy in sub-Saharan Africa

Olatunji,

Patel,

Graef

et al. 2023

Front. Oncol.

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IntroductionThe Lancet Oncology Commission for sub-Saharan Africa (SSA) predicts that cancer deaths will double from 520,158 per year to more than 1 million per year by the year 2040. These striking figures indicate a need to urgently evaluate cancer treatment infrastructure and resources in the region. Studies have found immunotherapy to be effective for the treatment of advanced-stage cancer, which almost 70% of patients in SSA present with. Despite immunotherapy’s significant therapeutic potential, its utilization in SSA is not well documented. The purpose of this study was to evaluate the landscape of immunotherapy in SSA.MethodsA Qualtrics survey assessing the existing infrastructure and training for safe immunotherapy administration was developed and distributed online via email and WhatsApp to 3,231 healthcare providers across SSA, with a target audience of healthcare providers serving patients with cancer. The survey contained 22 questions evaluating the accessibility, use, knowledge, and training on immunotherapy in SSA. Responses were collected between January and February 2023. Microsoft Excel was used to summarize and visually present the distribution of responses as counts and proportions.Results292 responses were included from 28 countries in SSA. 29% of all respondents indicated their clinic has easy access to cancer immunotherapy and 46% indicated their clinic currently practices it. Of clinics that practiced immunotherapy (n = 133), 12% used genomic sequencing to assess the tumor mutational burden biomarker, and 44% assessed expression of the PD-L1 biomarker prior to immunotherapy administration. 46% of all respondents were familiar with immunotherapy. 11% indicated being adequately trained to administer it. Of these (n=33), 52% indicated also being trained to manage immune-related adverse events related to immunotherapy administration.ConclusionImmunotherapy utilization and training is low in SSA and insufficient for the rising cancer burden. Increased accessibility and usage of biomarker testing to predict immunotherapy response, incorporation of immunotherapy training into continuous medical education, and increased access to immunotherapy drugs may be prerequisites for expanded utilization of immunotherapy in SSA.

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Section: Discussionmentioning

confidence: 99%

Utilization of cancer immunotherapy in sub-Saharan Africa

Olatunji,

Patel,

Graef

et al. 2023

Front. Oncol.

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“…A coordinated approach is needed to leverage the investments and achievements made to date across different disease programs, enabling the building, strengthening and maintenance of laboratory capacity and networks. [ 36 ]…”

Section: Discussionmentioning

confidence: 99%

Acceptability and feasibility of tests for infection, serological testing, and photography to define need for interventions against trachoma

Renneker,

Mtuy,

Kabona

et al. 2024

PLoS Negl Trop Dis

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Background Trachoma causes blindness due to repeated conjunctival infection by Chlamydia trachomatis (Ct). Transmission intensity is estimated, for programmatic decision-making, by prevalence of the clinical sign trachomatous inflammation—follicular (TF) in children aged 1–9 years. Research into complementary indicators to field-graded TF includes work on conjunctival photography, tests for ocular Ct infection, and serology. The perceived acceptability and feasibility of these indicators among a variety of stakeholders is unknown. Methodology Focus group discussions (FGDs) with community members and in-depth interviews (IDIs) with public health practitioners in Tanzania were conducted. FGDs explored themes including participants’ experience with, and thoughts about, different diagnostic approaches. The framework method for content analysis was used. IDIs yielded lists of perceived strengths of, and barriers to, implementation for programmatic use of each indicator. These were used to form an online quantitative survey on complementary indicators distributed to global stakeholders via meetings, mailing lists, and social media posts. Results Sixteen FGDs and 11 IDIs were conducted in October–November 2022. In general, all proposed sample methods were deemed acceptable by community members. Common themes included not wanting undue discomfort and a preference for tests perceived as accurate. Health workers noted the importance of community education for some sample types. The online survey was conducted in April–May 2023 with 98 starting the questionnaire and 81 completing it. Regarding barriers to implementing diagnostics, the highest agreement items related to feasibility, rather than acceptability. No evidence of significant differences was found in responses pertaining to community acceptability based on participant characteristics. Conclusions All of the indicators included were generally deemed acceptable by all stakeholders in Tanzania, although community education around the benefits and risks of different sample types, as well as addressing issues around feasibility, will be key to successful, sustainable integration of these indicators into trachoma programs.

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“…All analyses were performed in the Ranontsika laboratory in Toamasina and did not require shipment of samples to external laboratories; this is important from the standpoint of building research capacity within Madagascar [38,54].…”

Section: Quantifying Bacterial Concentrations In Watermentioning

confidence: 99%

Occurrence and Mitigation of Bacterial Regrowth in Stored Household Water in Eastern Coastal Madagascar

Judah,

Andriambololonirina,

Rakotoarisoa

et al. 2024

Water

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In communities where people lack on-demand, safely managed drinking water, stored household water often becomes contaminated by fecal bacteria, regardless of the source-water quality. The objectives of this paper are to assess and control bacterial contamination in stored household water in Toamasina, a rapidly urbanizing city in eastern coastal Madagascar. We collected samples of source water and stored household water from 10 representative households that use different water sources and different storage strategies, and we analyzed the samples for several fecal indicator bacteria. We also tested three methods that residents of Toamasina could realistically employ for cleaning their household water storage vessels, assessing the effect of the cleaning methods on measured bacterial levels in the water. Consistent with the previous literature, we found that concentrations of total coliforms in stored household water were significantly higher than in the corresponding source water (p < 0.05). In 100% of households that stored their water in 20 L polyethylene jerrycans (n = 4), biofilms on the walls of the jerrycan harbored total coliforms and Enterococcus. The use of a closed storage container was, on its own, not found to provide a meaningful protective effect against bacterial regrowth; to be protective, closed storage containers must be combined with high-quality source water and/or with adequate cleaning to prevent biofilm formation. A dilute solution of sodium hypochlorite, known locally as Sûr’Eau or Manadio Rano, was both the most effective and the least expensive method for cleaning household water storage containers. We conclude that regular and effective cleaning of storage containers is an essential component of safe water storage. Because household storage of collected water is common in many low- and middle-income countries, these results are important towards the worldwide achievement of the United Nations’ Sustainable Development Goal 6.

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Strengthening diagnostic capacity in Africa as a key pillar of public health and pandemic preparedness

Cited by 9 publications

References 15 publications

Utilization of cancer immunotherapy in sub-Saharan Africa

Utilization of cancer immunotherapy in sub-Saharan Africa

Acceptability and feasibility of tests for infection, serological testing, and photography to define need for interventions against trachoma

Occurrence and Mitigation of Bacterial Regrowth in Stored Household Water in Eastern Coastal Madagascar

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