Esophagogastroduodenoscopy in a Public Referral Hospital in Lilongwe, Malawi: Spectrum of Disease and Associated Risk Factors

Wolf, Lindsey L.; Ibrahim, Rahim; Miao, Changchun; Muyco, Arturo P; Hosseinipour, Mina C.; Shores, Carol G.

doi:10.1007/s00268-012-1490-7

Cited by 18 publications

(18 citation statements)

References 20 publications

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“…The study also revealed higher incidence in patients from the Central and Eastern regions compared to Western Tanzania. This study confirmed previous findings about higher rates among older patients, higher male-to-female ratio, and higher SCC compared to AC on EC in East Africa [4,5] . Future studies should further address the difference in geographic distribution of EC in Tanzania.…”

Section: Discussionsupporting

confidence: 82%

“…Other studies have reported that HIV is a risk factor for EC [27,28] . The missing data for tobacco smoking, alcohol intake, non-HIV viral infections, and other lifestyle factors, which are risk factors for EC, was also a limitation of this study [3][4][5] . This study confirmed the clinical impressions of physicians at ORCI of a higher proportion of EC patients from the Kilimanjaro region.…”

Section: Discussionmentioning

confidence: 99%

“…Some known risk factors for EC include age, sex, tobacco smoking, alcohol intake, obesity, and reflux [3][4][5] . No significant differences between regions with respect to age and sex exist.…”

Section: Discussionmentioning

confidence: 99%

“…There are two histologic types of EC that are commonly diagnosed, squamous cell carcinoma (SCC) and adenocarcinoma (AC). SCC has been linked to tobacco and alcohol use while AC has been linked to diet and esophageal reflux; both are associated with older age [3][4][5] . The incidence of esophageal AC is often significantly higher in developed than developing countries while the incidence of SCC is usually higher in developing countries, including Africa, than developed countries [6,7] .…”

Section: Introductionmentioning

confidence: 99%

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Clinical and epidemiologic variations of esophageal cancer in Tanzania

Gabel¹,

Chamberlain²,

Ngoma³

et al. 2016

WJGO

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AIM:To estimate the incidence of esophageal cancer (EC) in Kilimanjaro in comparison to other regions in Tanzania. METHODS:We also examined the clinical, epidemiologic, and geographic distribution of the 1332 EC patients diagnosed and/or treated at Ocean Road Cancer Institute (ORCI) during the period 2006-2013. Medical records were used to abstract patient information on age, sex, residence, smoking status, alcohol consumption, tumor site, histopathologic type of tumor, date and place of diagnosis, and type and date of treatment at ORCI. Regional variation of EC patients was investigated at the level of the 26 administrative regions of Tanzania. Total, age-and sex-specific incidence rates were calculated. RESULTS:Male patients 55 years and older had higher incidence of EC than female and younger patients. Of histopathologically-confirmed cases, squamous-cell carcinoma represented 90.9% of histopathologic types of tumors. The administrative regions in the central and

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Section: Discussionsupporting

confidence: 82%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Clinical and epidemiologic variations of esophageal cancer in Tanzania

Gabel¹,

Chamberlain²,

Ngoma³

et al. 2016

WJGO

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“…Additionally, looking at gastrointestinal endoscopy (GE) practice at KCH, Lindsay Wolf has described the spectrum of disease among patients with GI symptoms. Dysphagia (37%), haematemesis (21%), and epigastric pain (16%) are the most common indications for endoscopy whilst oesophageal cancer (27%) and oesophageal varices (17%) are the common diagnoses [4]. This clearly means that the importance for GE at KCH does not need to be overemphasized.…”

mentioning

confidence: 87%

Feasibility of Gastrointestinal Endoscopy Training in Surgery Residency at a Public Referal Hospital in Malawi

Mulima¹,

Kajombo²,

Hendrickse³

2017

JBM

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Objective: We set out to explore the impact of gastrointestinal (GI) endoscopy training on the surgery residency program at Kamuzu Central Hospital (KCH), Lilongwe, Malawi. Methods: We reviewed the hospital and published data regarding GI endoscopy and the surgical training at KCH from 2009 to 2015. The endoscopy database was reviewed determining endoscopic procedures done during the same period. Results: Since the onset of surgical residency program at KCH in 2009, 7 residents (5 now COSECSA Fellows) have been trained as independent GI endoscopists with support from the British Society of Gastroenterology andLiverpool Malawi Wellcome trust. Between them, with supervision, 1304 upper and 28 lower GI scopes have been done; 22% therapeutic. Endoscopy capacity has improved from an average of 12 patients per week to about 30 patients per week with a well-developed oesophageal variceal banding and tumour stenting capacity. Weekly endoscopy training lists by the fellows have also been established. During the same time period, 3 papers have been published from the endoscopy data with the residents as principle investigators or co-authors. Conclusion: With dedicated support endoscopy training during surgical residency is feasible in resource poor settings and improves diagnostic capacity for better patient care ultimately benefiting trainees in gaining endoscopy diagnostic and therapeutic skills, appreciating disease spectrum and management, and exposure to research skills.

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Informing etiologic research priorities for squamous cell esophageal cancer in Africa: A review of setting‐specific exposures to known and putative risk factors

McCormack

Menya

Munishi

et al. 2016

Intl Journal of Cancer

125

106

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Oesophageal squamous cell carcinoma (ESCC) is one of the most common cancers in most Eastern and Southern African countries, but its aetiology has been understudied to date. To inform its research agenda, we undertook a review to identify, of the ESCC risk factors that have been established or strongly suggested worldwide, those with a high prevalence or high exposure levels in any ESCC-affected African setting and the sources thereof. We found that for almost all ESCC risk factors known to date, including tobacco, alcohol, hot beverage consumption, nitrosamines and both inhaled and ingested PAHs, there is evidence of population groups with raised exposures, the sources of which vary greatly between cultures across the ESCC corridor. Research encompassing these risk factors is warranted and is likely to identify primary prevention strategies.

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Esophagogastroduodenoscopy in a Public Referral Hospital in Lilongwe, Malawi: Spectrum of Disease and Associated Risk Factors

Abstract: EGD is a limited resource at KCH; patient selection should be guided by patient age and indication. The high burden of esophageal cancer and varices in Malawi suggests that therapeutic endoscopy would be beneficial.

Cited by 18 publications

References 20 publications

Clinical and epidemiologic variations of esophageal cancer in Tanzania

Clinical and epidemiologic variations of esophageal cancer in Tanzania

Feasibility of Gastrointestinal Endoscopy Training in Surgery Residency at a Public Referal Hospital in Malawi

Informing etiologic research priorities for squamous cell esophageal cancer in Africa: A review of setting‐specific exposures to known and putative risk factors

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