Global access to dermatopathology services: Physician survey of availability and needs in sub-Saharan Africa

Dermatopathology in sub‐Saharan Africa: a systematic 5‐year analysis of all histopathological diagnoses from the Regional Dermatology Training Centre (RDTC) in Moshi, Tanzania

“…In the literature there are only few studies with histological analyses of inflammatory skin conditions in African patients. Two studies from SSA 6,16 reported frequencies of inflammatory skin conditions similar to those we found. In our study psoriasis vulgaris was the most frequent specific inflammatory diagnosis.…”

“…[10][11][12] In contrast to western countries, in SSAC hospitals pathology laboratories are rare and rudimentary, 13 and almost invariably restricted to academic medical centres and private hospitals. [14][15][16] The provision of quality pathology/dermatopathology services in SSAC is critically hampered by various factors, including shortage of well-trained specialists and technicians, the rudimentary working conditions, lack of technical equipment and infrastructures, insufficient number of specimens and inadequate training. 6,8,13,14,16 As a consequence limited data about pathological diagnoses in Africa are available.…”

“…[14][15][16] The provision of quality pathology/dermatopathology services in SSAC is critically hampered by various factors, including shortage of well-trained specialists and technicians, the rudimentary working conditions, lack of technical equipment and infrastructures, insufficient number of specimens and inadequate training. 6,8,13,14,16 As a consequence limited data about pathological diagnoses in Africa are available. 4,17,18 Diagnostic delays and misdiagnoses critically affect patients' health and disease prognosis, with potentially devastating consequences for professional and social activities of affected patients.…”

A retrospective review of patients with Kaposi's sarcoma in Botswana

“…In resource‐rich settings, the diagnosis of KS is routinely confirmed with histopathology; however, diagnosis in resource‐limited settings is challenging due to lack of access to dermatologists, supplies, and the scarce availability of dermatopathology services. In a survey study of SSA nations, 86% of countries reported having histology processing services and a pathologist, but only 14% reported having a dermatopathologist . In addition, long wait times (>1 month) seem to dissuade use of this diagnostic tool .…”

“…In a survey study of SSA nations, 86% of countries reported having histology processing services and a pathologist, but only 14% reported having a dermatopathologist . In addition, long wait times (>1 month) seem to dissuade use of this diagnostic tool . Without access to reliable histopathology, clinicians must rely heavily on clinical judgment, which can be particularly difficult in immunocompromised patients where presentations can vary widely and the initiation of incorrect empiric therapy can have significant consequences.…”