scholarly journals International Radiotherapy Referrals From Rural Rwanda: Implementation Processes and Early Clinical Outcomes

2018 ◽  
pp. 1-12
Author(s):  
Maud Hanappe ◽  
Lowell T. Nicholson ◽  
Shekinah N.C. Elmore ◽  
Alexandra E. Fehr ◽  
Jean Bosco Bigirimana ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Head And Neck ◽  
Low Income ◽  
Cancer Care ◽  
Sub Saharan Africa ◽  
Resource Limited Settings ◽  
Cancer Centre ◽  
Resource Limited ◽  
Centre Of Excellence ◽  
Sub Saharan

Purpose Low- and middle-income countries disproportionately comprise 65% of cancer deaths. Cancer care delivery in resource-limited settings, especially low-income countries in sub-Saharan Africa, is exceedingly complex, requiring multiple modalities of diagnosis and treatment. Given the vast human, technical, and financial resources required, access to radiotherapy remains limited in sub-Saharan Africa. Through 2017, Rwanda has not had in-country radiotherapy services. The aim of this study was to describe the implementation and early outcomes of the radiotherapy referral program at the Butaro Cancer Centre of Excellence and to identify both successful pathways and barriers to care. Methods Butaro District Hospital is located in a rural area of the Northern Province and is home to the Butaro Cancer Centre of Excellence. We performed a retrospective study from routinely collected data of all patients with a diagnosis of cervical, head and neck, or rectal cancer between July 2012 and June 2015. Results Between 2012 and 2015, 580 patients were identified with these diagnoses and were potential candidates for radiation. Two hundred eight (36%) were referred for radiotherapy treatment in Uganda. Of those referred, 160 (77%) had cervical cancer, 31 (15%) had head and neck cancer, and 17 (8%) had rectal cancer. At the time of data collection, 101 radiotherapy patients (49%) were alive and had completed treatment with no evidence of recurrence, 11 (5%) were alive and continuing treatment, and 12 (6%) were alive and had completed treatment with evidence of recurrence. Conclusion This study demonstrates the feasibility of a rural cancer facility to successfully conduct out-of-country radiotherapy referrals with promising early outcomes. The results of this study also highlight the many challenges and lessons learned in providing comprehensive cancer care in resource-limited settings.

Diagnosis and management of antiretroviral-therapy failure in resource-limited settings in sub-Saharan Africa: challenges and perspectives

2010 ◽  
Vol 10 (1) ◽  
pp. 60-65 ◽  
Author(s):  
Anthony D Harries ◽  
Rony Zachariah ◽  
Joep J van Oosterhout ◽  
Steven D Reid ◽  
Mina C Hosseinipour ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Sub Saharan Africa ◽  
Therapy Failure ◽  
Resource Limited Settings ◽  
Diagnosis And Management ◽  
Resource Limited ◽  
Sub Saharan

scholarly journals EDITORIAL: COVID-19: Rebooting pharmacy education in resource-limited settings

2021 ◽  
pp. 67-70
Author(s):  
Jennie Lates ◽  
Dan Kibuule
Keyword(s):  
Health Systems ◽  
World Health Organisation ◽  
Pharmacy Education ◽  
Sub Saharan Africa ◽  
World Health ◽  
Resource Limited Settings ◽  
Non Communicable Diseases ◽  
High Burden ◽  
Resource Limited ◽  
Sub Saharan

Globally, the COVID-19 pandemic has aggravated inequalities in access to quality pharmacy education, particularly in resource-limited settings in Africa (Engle, 2020; Fuller et al., 2020). This is a serious concern for Africa especially, given that sub-Saharan Africa ranks lowest on the global pharmaceutical workforce index and has a disproportionately high burden of infectious and non-communicable diseases, combined with weak health systems (World Health Organisation [WHO], 2013; Bates et al., 2018).

scholarly journals Simple Paper-Based Test for Measuring Blood Hemoglobin Concentration in Resource-Limited Settings

2013 ◽  
Vol 59 (10) ◽  
pp. 1506-1513 ◽  
Author(s):  
Xiaoxi Yang ◽  
Nathaniel Z Piety ◽  
Seth M Vignes ◽  
Melody S Benton ◽  
Julie Kanter ◽  
...  
Keyword(s):  
Low Income ◽  
Low Cost ◽  
Hemoglobin Concentration ◽  
Comparison Method ◽  
Sub Saharan Africa ◽  
Small Samples ◽  
Diagnostic Tools ◽  
Resource Limited Settings ◽  
Resource Limited ◽  
Oxygen Carrying Capacity

BACKGROUND The measurement of hemoglobin concentration ([Hb]) is performed routinely as a part of a complete blood cell count to evaluate the oxygen-carrying capacity of blood. Devices currently available to physicians and clinical laboratories for measuring [Hb] are accurate, operate on small samples, and provide results rapidly, but may be prohibitively expensive for resource-limited settings. The unavailability of accurate but inexpensive diagnostic tools often precludes proper diagnosis of anemia in low-income developing countries. Therefore, we developed a simple paper-based assay for measuring [Hb]. METHODS A 20-μL droplet of a mixture of blood and Drabkin reagent was deposited onto patterned chromatography paper. The resulting blood stain was digitized with a portable scanner and analyzed. The mean color intensity of the blood stain was used to quantify [Hb]. We compared the performance of the paper-based Hb assay with a hematology analyzer (comparison method) using blood samples from 54 subjects. RESULTS The values of [Hb] measured by the paper-based assay and the comparison method were highly correlated (R2 = 0.9598); the standard deviation of the difference between the two measurements was 0.62 g/dL. The assay was accurate within 1 g/dL 90.7% of the time, overestimating [Hb] by ≥1 g/dL in 1.9% and underestimating [Hb] by ≥1 g/dL in 7.4% of the subjects. CONCLUSIONS This study demonstrates the feasibility of the paper-based Hb assay. This simple, low-cost test should be useful for diagnosing anemia in resource-limited settings, particularly in the context of care for malaria, HIV, and sickle cell disease patients in sub-Saharan Africa.

scholarly journals Implementing a mobile diagnostic unit to increase access to imaging and laboratory services in western Kenya

2018 ◽  
Vol 3 (5) ◽  
pp. e000947 ◽  
Author(s):  
Roshni Dhoot ◽  
John M Humphrey ◽  
Patrick O'Meara ◽  
Adrian Gardner ◽  
Clement J McDonald ◽  
...  
Keyword(s):  
Healthcare Workers ◽  
Health Facilities ◽  
Sub Saharan Africa ◽  
Resource Limited Settings ◽  
Western Kenya ◽  
Remote Areas ◽  
Diagnostic Unit ◽  
Resource Limited ◽  
Laboratory Services ◽  
Sub Saharan

Access to basic imaging and laboratory services remains a major challenge in rural, resource-limited settings in sub-Saharan Africa. In 2016, the Academic Model Providing Access to Healthcare programme in western Kenya implemented a mobile diagnostic unit (MDU) outfitted with a generator-powered X-ray machine and basic laboratory tests to address the lack of these services at rural, low-resource, public health facilities. The objective of this paper is to describe the design, implementation, preliminary impact and operational challenges of the MDU in western Kenya. Since implementing the MDU at seven rural health facilities serving a catchment of over half a million people, over 4500 chest radiographs have been performed, with one or more abnormalities detected in approximately 30% of radiographs. We observed favorable feedback and uptake of MDU services by healthcare workers and patients. However, various operational challenges in the design and construction of the MDU and the transmission and reporting of radiographs in remote areas were encountered. Our experience supports the feasibility of deploying an MDU to increase access to basic radiology and laboratory services in rural, resource-limited settings.

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