Understanding the challenges of delivering radiotherapy in low- and middle-income countries in Africa

Ige, Taofeeq; Lewis, Penney; Shelley, C.; Pistenmaa, David; Coleman, C. Norman; Aggarwal, Ajay; Dosanjh, Manjit; Khoudri, Saad; Zergoug, Ismail; Eduardo, Higidio Miezi; Bvochora‐Nsingo, Memory; Fulu, Kuhle; Ralefala, Tlotlo; Grover, Surbhi; Maison-Mayeh, Anne Marthe; Ndi, Samba Richard; Attalla, Ehab M.; Deiab, Nashaat A.; Belay, Eskadmas Yinesu; Acquah, George Felix; Amankwaa-Frempong, Emmanuel; Foy, Hubert; Ngigi, Ejidio; Badi, Fadwa; Elburi, Ihab; Harivony, Tovo; Kone, Aphousalle; Maiga, Siaka; Tolba, Ahmedou; Mootoosamy, Seeven; El-Boutayeb, Salwa; Momade, Ainadine; Midzi, Wilfred; Grobler, Melanie; Aruah, Simeon Chinedu; Kra, Joel; Diagne, M.; Trauernicht, Christoph; Elbashir, Fawzia; Ali, Nadir Abd Ellatif; Makwani, Hellen; Yusufu, Shaid; Farhat, L.; Mounir, Besbes; Kavuma, Awusi; Azangwe, G.

doi:10.1016/j.jcpo.2022.100372

Cited by 5 publications

(3 citation statements)

References 15 publications

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“…This observation could be attributed to the scarcity and disparity in the distribution of radiation therapy resources across Africa, with only 23% of the continent having access to radiation services. 14 , 38 According to a recent report by the International Atomic Energy Agency, most of the radiation therapy facilities are concentrated in North Africa, especially Egypt, whereas other Sub-Saharan countries have very few facilities. 14 It is possible that the unequal distribution of radiation therapy facilities may reflect the increased level of investment and research in breast cancer radiation in North Africa compared with other Sub-Saharan African countries.…”

Section: Discussionmentioning

confidence: 99%

Radiation Therapy for Breast Cancer in Africa

Oppong,

Yeboah,

Owusu-Ansah

et al. 2024

Advances in Radiation Oncology

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Section: Discussionmentioning

confidence: 99%

Radiation Therapy for Breast Cancer in Africa

Oppong,

Yeboah,

Owusu-Ansah

et al. 2024

Advances in Radiation Oncology

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“…Notable challenges with communication among collaborators include time zone differences, language barriers, cultural practices, and scheduling difficulties. [25][26][27] The remote environment has eased some of these obstacles using virtual meetings and telehealth tools. Collaborators in LMICs often struggle with lack of resources, poor health care infrastructure, high patient volume, minimal ancillary support, ethical challenges, political uncertainty, and provider burnout.…”

Section: Discussionmentioning

confidence: 99%

Establishment of Twinning Partnership to Improve Pediatric Radiotherapy Outcomes Globally

Ali,

Amare,

Fekadu

et al. 2024

JCO Glob Oncol

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PURPOSE Pediatric radiotherapy is a necessary and challenging component of oncologic care for children in low- and middle-income countries (LMICs). Collaboration between institutions in LMICs and high-income countries (HICs) has been shown to be effective in improving oncologic treatment outcomes; however, literature regarding pediatric radiotherapy twinning partnerships is limited. METHODS Emory University has a long-standing twinning collaboration with Tikur Anbessa Specialized Hospital (TASH) for certain medical specialties. After securing institutional funding, a faculty member and a resident from the Emory University Department of Radiation Oncology set out to establish a twinning program with TASH for pediatric radiotherapy. RESULTS Emory and TASH faculty and residents established initial communications virtually via email and video correspondence. TASH residents and faculty completed surveys regarding pediatric radiotherapy institutional and educational needs to outline goals of collaboration. Five lectures and case-based practicums were identified focused on Wilms tumor, medulloblastoma, rhabdomyosarcoma, Hodgkin lymphoma, and palliative radiotherapy. The Emory team then conducted a visit to TASH during which lectures and practicums were delivered. The Emory team directly observed and guided simulation and treatment planning procedures. TASH residents practiced decision making, simulation, contouring, and field placement for Wilms tumor cases on the basis of didactics and feedback provided by the Emory team. Additionally, a needs assessment regarding pediatric oncologic resources was completed. Clinical care pathways and standard operating procedures were drafted by collaborators. Virtual peer-review sessions were established to continue collaborations abroad and plan for next in-person visit. CONCLUSION Collaborative efforts by global experts have helped to establish and improve treatment protocols for childhood cancer. The presented twinning experience may serve as a model for other LMIC and HIC centers for establishing similar partnerships.

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“…23 This could contribute to failure of honouring service contracts for maintaining imaging and radiotherapy equipment, timely replacement of machines and the chronic shortage of anticancer drugs in government facilities. 24 The indirect social and economic costs of prostate cancer treatment fall back on the patient. With centralised tertiary services most patients must travel vast geographic distances to access care.…”

Section: Original Research Open Accessmentioning

confidence: 99%

Defining national research priorities for prostate cancer in Zambia: using the Delphi process for comprehensive cancer policy setting in sub-Saharan Africa

Lombe,

Mwamba,

Simwinga

et al. 2024

bmjonc

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ObjectivesLocally led research on cancer is needed in sub-Saharan Africa to set feasible research priorities that inform national policy. The aim of this project was to develop a research agenda for national cancer control planning, using a nationally driven approach, focused on barriers to diagnosis and high-quality treatment for prostate cancer in Zambia.Methods and analysisThis was a Delphi process. 29 stakeholders were scored barriers on feasibility, the proportion of patients affected, the impact on patient outcomes and if there was a potential to address health systems barriers meaningfully. There were three rounds (R) to the process: (R1 and R2) by electronic survey and (R3) in-person meeting. In R1 statements scoring above 15 from over 70% of participants were prioritised immediately for R3 discussion. Those scoring below 30% were dropped and those in between were re-surveyed in R2.Results22 and 17 of the 29 stakeholders responded to R1 and R2. 14 stakeholders attended R3. National priority research areas for prostate cancer in Zambia were identified as prostate cancer awareness; building affordable high-quality diagnostic capacity; affordability of specialist cancer treatments; supporting better access to medicines; delivery and coordination of services across the pathway and staff training.ConclusionThe suggested seven priority areas allow for the development of the prostate cancer control programme to be conducted in a holistic manner. The expectation is with this guidance international partners can contribute within the frameworks of the local agenda for sustainable development to be realised.

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Understanding the challenges of delivering radiotherapy in low- and middle-income countries in Africa

Cited by 5 publications

References 15 publications

Radiation Therapy for Breast Cancer in Africa

Radiation Therapy for Breast Cancer in Africa

Establishment of Twinning Partnership to Improve Pediatric Radiotherapy Outcomes Globally

Defining national research priorities for prostate cancer in Zambia: using the Delphi process for comprehensive cancer policy setting in sub-Saharan Africa

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