Development of imunohistochemistry services for cancer care in western Kenya: implications for low-and middle-income countries

Background: Cancer is becoming a major cause of mortality in low- and middle-income countries. Unlike infectious disease; malignancy and other chronic conditions require significant supportive infrastructure for diagnostics; staging and treatment. In addition to morphologic diagnosis; diagnostic pathways in oncology frequently require immunohistochemistry (IHC) for confirmation. We present the experience of a tertiary-care hospital serving rural western Kenya; which developed and validated an IHC laboratory in support of a growing cancer care service. Objectives; methods and outcomes: Over the past decade; in an academic North-South collaboration; cancer services were developed for the catchment area of Moi Teaching and Referral Hospital in western Kenya. A major hurdle to treatment of cancer in a resource-limited setting has been the lack of adequate diagnostic services. Building upon the foundations of a histology laboratory; strategic investment and training were used to develop IHC services. Key elements of success in this endeavour included: translation of resource-rich practices to are source-limited setting; such as using manual; small-batch IHC instead of disposable- and maintenance-intensive automated machinery; engagement of outside expertise to develop reagent-efficient protocols and supporting all levels of staff to meet the requirements of an external quality assurance programme. Conclusion: Development of low- and middle-income country models of services; such as the IHC laboratory presented in this paper; is critical for the infrastructure in resource-limited settings to address the growing cancer burden. We provide a low-cost model that effectively develops these necessary services in a challenging laboratory environment

Paediatric head and neck cancers in Nigeria: implications for treatment planning in resource limited settings

Background: The head and neck (H/N) is a common site for childhood cancers. This study examined all cases of H/N childhood cancers diagnosed in a major teaching hospital in Nigeria over 18 years to determine patterns of broad lineage cancer groups. Materials and Methods: Primary pediatric childhood malignancies diagnosed between 1990 and 2008 were analysed. Logistic regression models were fitted to determine significant clinical correlates of childhood cancer. Results: Lymphomas were the commonest cancers (49.5). After controlling for site and age; there was no significant difference in the incidence of Burkitt's lymphoma (BL) by sex ( P=0.423). The jaw bones (mandible and maxilla) were the commonest sites in the H/N for involvement of BL; with over 20 times the odds of occurrence when compared to other non-jaw sites of the H/N region (Adjusted Odds Ratio [AOR]=21.41; P0.001). Among the jaw bones; there was no significant difference in the occurrence of BL ( P

Cancer management in Sudan: current status and future perspectives

Introduction:Sudan is one of the developing countries that face a great challenge with cancer management.About 5700 cases had been seen during year 2007 in Radiation and Isotope Center- Khartoum (RICK)and Institute of Nuclear medicine; Molecular biology; and Oncology (INMO) Wadmedani which are the only cancer centers in Sudan. Purpose:Aim of this work is to highlight the difficulties of cancer management in Sudan and to propose possible solutions.Methods:This paper evaluates the current situation of cancer management in Sudan through reviewing of data available in cancer centers and reports from the Sudan national bureau of statistic.Suggestions are also made for cancer control plan in Sudan having the currentsituation in mind and guided by the published international data on cancer control.Results:The preliminary analysis of the available data reveals that Sudan has very limited resources available to deal with cancer and the service provided is not evenly distributed.Conclusion:Establishment of new centers is extremely needed with special attention to good distribution of services.To achieve such a goal training of more staff and upgrading of the existing centers is mandatory to manage all types of cancer.Cancer registry is the right way to plan for cancer control in sudan