44 research outputs found
Experiences of women receiving high dose rate brachytherapy for cervical cancer at ocean road cancer institute Dar-es-salaam Tanzania
No full textThe objective of this study was to present a descriptive summary of the experiences of women treated with high dose rate brachytherapy for cervical cancer. A qualitative descriptive study design was used and 50 women who undergo high dose rate brachytherapy at Ocean Road Cancer Institute (ORCI) in Dar-es-salaam were selected. Qualitative interviewer administered questionnaire was used for data collection from cervical cancer patients treated between April 2019 to July 2019 for descriptive and thematic analysis of data. Qualitative interviewer administered questioning was done from which three themes arose: the patient perception, expectation and impressions, informational need, and psychological experiences. Many patients had good perception about brachytherapy although their first impression was bad. The study found the importance of provision of procedure information to patient which seems to improve their treatment experiences. The psychological experiences faced by patients before and during treatment included pain, distress, fear, humiliation and anxiety Pain was a major problem, as the preventative medication participants received had low efficiency in pain prevention hence did not protect them from experiencing pain. Opening and hanging their legs was a humiliating experience aggravated by the presence of doctors and nurses. Their belief that brachytherapy can cure their disease comforted them and gave them courage to endure the treatment, whilst caring staff comforted and supported them. In addition to individualized patient education, nurses should assess the level of pain women experience before, during and after receiving brachytherapy and advice the revision of pain management protocols. </p
Experiences of women receiving high dose rate brachytherapy for cervical cancer at ocean road cancer institute Dar-es-salaam Tanzania
No full textAssessing Concordance to an Intensified Upendo Ward Wilms Tumor Treatment Protocol in Tanzania: An Institutional Review
No full textBackground: In Tanzania Wilms tumor (WT) ranks second among the most frequently diagnosed childhood cancer. Due to late presentation an intensified treatment protocol was established aiming for tumor reduction before surgery for achieving better surgical outcomes. We used two indicators for measuring the protocol concordance. First indicator was assessing the number of patients that received radiotherapy and second was number of patients treated with the high-risk regimen as per the protocol indications.Methodology: This was a cross sectional study. Data was collected using a retrospective chart review of all children with WT at Muhimbili National Hospital Pediatric Oncology Unit for a period between April 2016 to May 2017 who were treated using the intensified treatment protocol (combination of two WT protocols with neoadjuvant as per SIOP-PODC and adjuvant as per modified SIOP International). Analysis was conducted using excel sheet and SPSS v20.Results: A total of 74 children were eligible. The median age was 3 years ranging from 6 months to 17 years with small female predisposition of 57% (n=42). On clinical presentation all patients presented with history of abdominal swelling. In terms of clinical stage; 45% (n= 33) and 43% (n= 32) presented with stage 4 and 3 disease, respectively. Radiotherapy treatment was administered to 30% (n=22). As per protocol stage III and IV disease require radiotherapy thus only 34% of eligible candidates received radiotherapy. On histology report; 34% (n = 25) reports were never found and 66% (n=49) were available. High-risk cases were 27% (n = 20). We noted high-risk regimen was given to 12% (n=9) of study participants; thus only 45% of eligible candidates received high-risk regimen. All patient had intention to treat on admission with noted 19% (n = 14) default rate.Conclusion: Measuring concordance with guidelines allows for identification of best practices, which in turn inform on quality improvements. This snapshot identified opportunities for improvement in protocol uptake in our unit.
Key words: Wilms Tumor, low income country, pediatric malignancy
Radiation therapists' perceptions of thermoplastic mask use for head and neck cancer patients undergoing radiotherapy at Ocean Road Cancer Institute in Tanzania: A qualitative study.
No full textIntroductionA thermoplastic mask is the most widely used immobilization device for head and neck cancer patients undergoing radiotherapy. The radiation therapist is the staff responsible to prepare these masks and set-up the patients for treatment, a procedure that requires time, patience, and precision. An understanding of Radiation therapists' perceptions regarding thermoplastic mask use will help design interventions to address challenges encountered in its use. This study explored Radiation therapists' perceptions of thermoplastic mask use for head and neck cancer patients undergoing radiotherapy at Ocean Road Cancer Institute in Tanzania.Material and methodsAn exploratory qualitative study design was used to explore thermoplastic mask use for head and neck cancer patients undergoing radiotherapy. Semi-structured in-depth interviews were conducted, involving fifteen Radiation therapists from Ocean Road Cancer Institute in Tanzania between March and May 2021. A thematic analysis method was used to identify themes from data scripts.ResultsFour themes emerged that reflected radiation therapists' perceptions of thermoplastic mask use for head and neck cancer immobilization among patients undergoing radiotherapy. Emerged themes were (1) Perceived benefits and limitations of thermoplastic mask use, (2) Refresher training and supervision requirements for effective use, (3) Proper storage for quality maintenance, and (4) Increased financial support and proper budgeting.ConclusionParticipants perceived better patient immobilization with a thermoplastic mask use. However, too often recycling of thermoplastic masks and the long waiting time between thermoplastic mask preparation and treatment delivery limits their effective use. For efficient use of thermoplastic masks, there is a need for Radiation therapists' refresher training and proper supervision, improving the storage system and increasing financial support for procuring new thermoplastic masks
Prevalence of blood stream infections and associated factors among febrile neutropenic cancer patients on chemotherapy at Ocean Road Cancer Institute, Tanzania
No full textAbstract Background Febrile Neutropenia (FN) caused by bacteria in cancer patients is associated with poor prognosis. The aim of this study was to determine the prevalence of FN and associated factors among cancer patients on chemotherapy at Ocean Road Cancer Institute (ORCI), Tanzania. Methods A cross-sectional study was conducted from June to September 2019. Study participants were conveniently recruited. A desk review of participants medical records was performed. Standard microbiological procedures used to culture and identify the bacterial isolates from the positive blood cultures of participants that presented with FN. Kirby-Bauer disc diffusion was used to perform the antibiotics susceptibility testing. SPSS version 20.0 and MS Excel were used in data entry and analysis. Chi-Square was used as a measure of association between various factors and neutropenia. P-value less than 0.05 was considered statistically significant. Results A total 213 participants were enrolled. Of these 76.1% were female. Most of the participants came from the Coast region. Majority of participants presented with breast Cancer (36.2%) and GIT (20.2%). The prevalence of FN and bacteremia was 5.6% and 35.3% respectively. Staphylococcus Aureus (60%) and Coagulase-Negative Staphylococci (40%) were the main isolates. Of the 6 isolates tested most were resistant to Co-Trimoxazole 4/6 (66.7%) and Doxycycline 3/6 (50%). FN was positively associated with chemotherapy regimen (P = 0.0001), platelets count (P = 0.0001) and use of G-CSF (P = 0.0001). Conclusion The prevalence of FN among the cancer patients on chemotherapy in Tanzania is low but associated with drug-resistant bacteria
Radiation therapists’ perceptions of thermoplastic mask use for head and neck cancer patients undergoing radiotherapy at Ocean Road Cancer Institute in Tanzania: A qualitative study
No full textIntroduction A thermoplastic mask is the most widely used immobilization device for head and neck cancer patients undergoing radiotherapy. The radiation therapist is the staff responsible to prepare these masks and set-up the patients for treatment, a procedure that requires time, patience, and precision. An understanding of Radiation therapists’ perceptions regarding thermoplastic mask use will help design interventions to address challenges encountered in its use. This study explored Radiation therapists’ perceptions of thermoplastic mask use for head and neck cancer patients undergoing radiotherapy at Ocean Road Cancer Institute in Tanzania. Material and methods An exploratory qualitative study design was used to explore thermoplastic mask use for head and neck cancer patients undergoing radiotherapy. Semi-structured in-depth interviews were conducted, involving fifteen Radiation therapists from Ocean Road Cancer Institute in Tanzania between March and May 2021. A thematic analysis method was used to identify themes from data scripts. Results Four themes emerged that reflected radiation therapists’ perceptions of thermoplastic mask use for head and neck cancer immobilization among patients undergoing radiotherapy. Emerged themes were (1) Perceived benefits and limitations of thermoplastic mask use, (2) Refresher training and supervision requirements for effective use, (3) Proper storage for quality maintenance, and (4) Increased financial support and proper budgeting. Conclusion Participants perceived better patient immobilization with a thermoplastic mask use. However, too often recycling of thermoplastic masks and the long waiting time between thermoplastic mask preparation and treatment delivery limits their effective use. For efficient use of thermoplastic masks, there is a need for Radiation therapists’ refresher training and proper supervision, improving the storage system and increasing financial support for procuring new thermoplastic masks
Clinicopathological Characteristics and Outcomes of Anal Squamous Cell Carcinoma Patients With and Without HIV Infection in Sub-Saharan Africa
No full textPURPOSEIn the past 20 years, the burden of anal cancer (AC) increased by 60% in the United States and over three-fold in Africa. Rates of AC have increased by 20× in people living with HIV and the highest (50×) in men with HIV who have sex with men. However, in sub-Saharan Africa (SSA) where HIV is endemic, data on clinicopathological characteristics and outcomes of patients with AC are lacking. To address this, we have investigated AC disease presentation, treatment outcomes, and its predictors in a cohort of patients who were either HIV-infected or HIV-uninfected in SSA.METHODSWe conducted a retrospective cohort study of patients with anal squamous cell carcinoma (SCC) treated at Ocean Road Cancer Institute in Dar es Salaam, Tanzania from January 2014 to December 2019. Associations between the study outcomes and their predictors were analyzed using univariate and multivariate analysis models.RESULTSA total of 59 patients with anal SCC were retrieved and had at least 2-year follow-up. The mean age was 53.9 (standard deviation ±10.5) years. While none of the patients presented with stage I disease, 64.4% had locally advanced disease. HIV infection was the major comorbidity (64.4%). The rate of complete remission at the end of treatment was at 49% while the 2-year overall survival (OS) and local recurrence-free survival were 86.4% and 91.3%, respectively. Despite high HIV coinfection in the cohort, AC treatment outcomes were not significantly associated with HIV status. Disease stage (P = .012) and grade (P = .030) were significantly associated with 2-year OS.CONCLUSIONPatients with anal SCC in Tanzania present mainly with locally advanced disease associated with high HIV prevalence. In this cohort, the SCC grade was independently associated with treatment outcomes unlike other factors such as HIV coinfection
Experiences of Patients using Thermoplastic masks for Radiotherapy of Head and Neck Cancers at Ocean Road Cancer Institute, Tanzania. A qualitative study.
No full textAbstract
Background: Head and neck cancer (HNC) patients undergoing radiotherapy (RT) require proper patient immobilization, for which a thermoplastic mask is used. Studies have reported a variety of patient experiences in using this device. Understanding these experiences in our local context is important to improve the current practice in the RT department. This study aimed at exploring the experiences of HNC patients using thermoplastic masks during RT at Ocean Road Cancer Institute in Dar es Salaam, Tanzania.
Methods: In-depth interviews were conducted in Swahili for thirteen purposively selected HNC patients who were undergoing RT treatment, using a semi-structured interview guide. Data were transcribed verbatim and translated into English and thematic analysis was done.
Results: There was a diverse understanding about thermoplastic masks among patients, and experiences of thermoplastic mask wearing varied, with patients expressing an experience of anxiety and discomfort during the first days of treatment and pain at later days of treatment.
Conclusion: Enhancing communication and ensuring the availability of staff numbers required during thermoplastic mask construction and treatment improves patients' understanding and comfortability as well as reduces anxiety. Also, regular assessment of pain and proper management of radiation-induced side effects among HNC patients is important during RT treatment
Breast Cancer in East Africa: Prevalence and Spectrum of Germline SNV/Indel and CNVs in BRCA1 and BRCA2 Genes Among Breast Cancer Patients in Tanzania
No full textBackground: Growing prevalence and aggressiveness of breast cancer (BC) among East African women strongly indicate that the genetic risk factor implicated in the etiology of the disease may have a key role. Germline pathogenic variants in BRCA1 and BRCA2 (BRCA1/2) are known to increase the lifetime risk of BC. This study investigated the prevalence and spectrum of germline single nucleotide variant/insertion and deletion (SNV/indel), and copy number variations (CNVs) in BRCA1/2 among Tanzanian BC patients, and evaluated the associations of identified variants with patient's socio-demographic and histopathological characteristics. Methods: One hundred BC patients were examined for BRCA1/2 variants using next-generation sequencing (NGS). Sanger sequencing and multiplex ligation-dependent probe amplification (MLPA) assay were performed for the confirmation of SNV/indel and CNVs, respectively. Results: Six germline SNV/indel pathogenic variants were detected from six unrelated patients. Five of these variants were identified in BRCA1, and one in BRCA2. We also identified, in one patient, one variant of uncertain clinical significance (VUS). CNV was not detected in any of the BC patients. Furthermore, we found that in our cohort, BRCA1/2 variant carriers were triple-negative BC patients (p = 0.019). Conclusions: Our study provides first insight into BC genetic landscape by the use of NGS in the under-represented East African Tanzanian populations. Our findings support the importance of genetic risk factors in BC etiology in Tanzania and showed a relatively high overall prevalence (6%) of germline BRCA1/2 pathogenic variants in BC patients. Therefore, our results indicate that BRCA1/2 pathogenic variants may well contribute to BC incidence in Tanzania. Thus, the identification of frequent variants in BRCA1/2 genes will enable implementation of rapid, inexpensive population-specific BRCA1/2 genetic testing, particularly for triple-negative BC patients known for their high prevalence in Tanzania. This will, in turn, greatly contributes to provide effective therapeutic strategies. © 2022 The Authors. Cancer Medicine published by John Wiley & Sons Ltd
Different thermoplastic mask types (A) S-type (B) U-type.
No full textDifferent thermoplastic mask types (A) S-type (B) U-type.</p
