Improving Immunohistochemistry Capability for Pediatric Cancer Care in the Central American and Caribbean Region: A Report From the AHOPCA Pathology Working Group

Abstract

Accessibility to immunohistochemistry (IHC) is invaluable to proper diagnosis and treatment of pediatric patients with malignant neoplasms. Whereas IHC is widely available in anatomic pathology laboratories in high-income countries, access to it in anatomic pathology laboratories of low- and middle-income countries remains a struggle, with many limitations. To advance the quality of the pathology service offered to children with cancer in areas with limited resources, a 5-day pathology training workshop was offered to pathologists and histotechnologists from various countries of the Central American and Caribbean region. An initial assessment of the workshop participants’ current laboratory capacities was performed, and a regional training center was selected. Didactic and hands-on activities were offered, and review and evaluation of the IHC slides produced during the training course were compared with original slides from the participants’ sites. This model of intensive 5-day training appears to be effective and can potentially be used in other budget-constrained regions. Moreover, it can serve as a continuing education activity for pathologists and histotechnologists, and as part of validations and quality improvement projects to build capacity and develop IHC assay proficiency in low- and middle-income countries.

Science and health for all children with cancer

“…Barriers to access can be due to the unavailability of services or the inability of patients to pay for these services in health care systems that primarily depend on families' outof-pocket contributions (29). Strategies to facilitate earlier and more accurate cancer diagnosis in LMIC include the use of telemedicine with local, cross-regional or international expert groups to complement on-site continuing education; both clinical referral networks and professional networks for local input or virtual input from international experts have been successfully implemented in LMIC (3,9,(30)(31)(32)(33)(34)(35). An example of such long-term collaboration is outlined later in this Review.…”