Oncology pharmacy units: a safety policy for handling hazardous drugs and related waste in low- and middle-income African countries-Angolan experience.

In African countries, higher rates of late-stage cancers at the time of first diagnosis are a reality. In this context, hazardous drugs (HDs), such as chemotherapy, play an important role and have immense benefits for patients' treatment. HDs should be handled under specific conditions. At least a class 5 environment primary engineering control (PEC), physically located in an appropriate buffer area, is mandatory for sterile HDs compounding, as well as administrative control, personal protective equipment, work practices and other engineering and environmental controls, in order to protect the environment, patient, and worker. The aim of this study is to describe the Angolan experience regarding the development of oncology pharmacy units and discuss international evidence-based guidelines on handling HDs and related waste. Measures to incorporate modern and economical solutions to upgrade or build adequate and safe facilities and staff training, in order to comply with international guidelines in this area, are crucial tasks for African countries of low and middle income.

Establishing of cancer units in low or middle income African countries: Angolan experience--a preliminary report.

INTRODUCTION: The number of cancer cases and related deaths worldwide is expected to double over the next 20-30 years. African countries will be the most affected by the burden of cancer. The improving economic situation of Angola creates conditions for an increase in life expectancy which by itself is associated with an increased risk of oncological diseases. Because cancer therapy requires a multidisciplinary approach, trained health professionals, satisfactory infrastructure and appropriate facilities, the availability of effective cancer therapy is a difficult task that requires support. The aim of this article is to share our experience achieved in the establishment of cancer units in Angola and to validate our checklist for this action. METHODS: The survey method was a questionnaire addressed to Angolan cancer units, in order to evaluate the usefulness and feasibility of a checklist developed by the authors--The Cancer Units Assessment Checklist for low or middle income African countries--which was used previously in the establishment of those units. Afterwards, the crucial steps taken for the establishing of the main sites of each cancer unit considering, facilities, resources and professionals, were also recorded. RESULTS: All cancer units reported that the checklist was a useful tool in the development of the cancer program for the improvement of the unit or the establishing of cancer unit sites. This instrument helped identifying resources, defining the best practice and identifying barriers. Local experts, who know the best practices in oncology and who are recognized by the local heads, are also important and they proved to be the major facilitators. CONCLUSION: The fight against cancer has just started in Angola. The training, education, advocacy and legislation are ongoing. According to our results, the assessment checklist for the establishment of cancer units is a useful instrument.

Cancer in Angola, resources and strategy for its control.

BACKGROUND: Cancer is an increasingly important health problem in Africa. The number of cancer cases in this region could double, ranging between 700 000 and 1 600 000 new cases in 2030. The mortality rate is higher than 80% and is explained, mainly, by a lack of early detection, diagnostics and treatment resources. In Angola, about 7,000 patients die of cancer every year. METHODS: Data were derived from open-ended interviews conducted in 2010-11 with health authorities, clinicians, nurses and Administration of Hospitals. According Angola epidemiological data, results of interviews and international published advocacy for cancer control we develop a potential strategy for its control. The objectives are to identify existing resources for cancer control and describe the needs thereto, in order to establish an oncological program to guide the development of Angola cancer control strategies. RESULTS: Malaria remains the leading cause of illness and death in Angola, and other communicable diseases remain a public health problem. However, 9 000 new cases of cancer are diagnosed each year.The most common types of cancer are: cancer of the cervix, breast, prostate, esophagus, stomach and head and neck, as well as cancers with infectious origin, such as Kaposi's sarcoma and liver and bladder cancer. The foundation for developing national cancer control strategies includes: oncological data; investment and training; identifying and removing barriers; guidance and protection of the patient. Angolan National Cancer Centre, Sagrada Esperança Clinic and Girassol Clinic are now developing a cancer program. CONCLUSION: Improving the economic situation of Angola creates conditions for an increase in life expectancy which in itself is associated with an increased risk of oncological diseases. On the other hand, infectious diseases, associated with the risk of malignant tumors, are endemic. Thus, an increase in patients with malignant disease is expected. A plan is therefore necessary to organize the response to this old but less visible nosologic situation.

The control of an epidemic outbreak of Marburg hemorrhagic fever in Angola, 2004-2005 / No disponible

Entre Octubre del 2004 y Septiembre del 2005 Angola vivió un brote epidémico de fiebre hemorrágica debida al virus Marburg. La epidemia se dio por oficialmente por concluida el 7 de Noviembre del 2005, y se consideró la más grave de las ocurridas en todo el mundo, con 252 casos y 227 muertes, lo que suponía una tasa de mortalidad del 90%. Considerando que es un agente patógeno de gran virulencia para el cual no hay vacunas o tratamiento específico, estas epidemias precisan de una enorme cantidad de recursos humanos, financieros y técnicos tanto nacionales como internacionales Es importante poner de manifiesto que el laboratorio del Center for Diseases Control de Atlanta fue el responsable del primer aislamiento del virus y de su identificación como causante de la epidemia. Posteriormente fue el encargado de monitorizar la epidemia y estudiar todas las muestras biológicas recogidas de los casos sospechosos. Hasta este momento ha sido imposible identificar el foco primario de la enfermedad, aunque existen sugerencias a nivel local sobre la posibilidad de que el hospital provincial de UIge haya sido el sitio inicial y responsable de la diseminación de la epidemia a través de la infección nosocomial. En una segunda fase la ausencia de una adecuada educación para la salud, el pánico y las tradiciones culturales locales fueron los elementos cruciales para la diseminación de la enfermedad a otras provincias del país. En este contexto, la participación de sociólogos y antropólogos fue un factor clave para el control de las epidemias, en paralelo a las medidas de bioseguridad y detección activa emprendidas (AU)

Angola has lived an epidemic outbreak of hemorrhagic fever caused by Marburg virus between October 2004 and September 2005. The epidemic was officially terminated in November 7th 2005, and considered the most severe ever occurred in the world, with 252 cases and 227 deaths, with a lethality rate of 90%. Considering that it is a pathogenic agent of great virulence for which there are no vaccines or specific treatment, these epidemics caused a huge recruitment of national and international human, financial and technical resources despite some local constraints. It must be outlined that CDC-Atlanta laboratory was the responsible for the first isolation of the virus as the cause of the epidemics, and later on, for monitoring the epidemics and manipulating all biological samples collected from suspected patients. Until now it was impossible to identify the primary focus of the disease, though there are suggestions from local oral comments that Uige provincial hospital may have been the initial site and responsible for the dissemination of the epidemics through nosocomial infection. In a second phase, lack of proper health education, panic and local cultural traditions were the crucial elements for disease spread to other provinces of the country. In this context, the participation of sociologist and anthropologists was a key factor for the epidemics control, in parallel with the biosafety and active survey measures undertaken (AU)