Repetitive Cancer Training for Community Healthcare Workers: an Effective Method to Strengthen Knowledge and Impact on the Communities: Results from a Pilot Training at Kilimanjaro Region, Tanzania

Singer, Regina; Henke, Antje; Alloyce, Julius Pius; Serventi, Furaha; Massawe, Anna; Henke, Oliver

doi:10.1007/s13187-019-01648-6

Cited by 6 publications

(7 citation statements)

References 16 publications

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“…In contrast, the ‘Carolina BC Study’ in the USA found that majority of the patients 61% did not have distant or lymph node metastasis at the time of diagnosis [ 36 ]. This might be a feature of either more aggressive BC and/or late stage presentation in indigenous Africans than in their Caucasian counterparts, driven by poor health knowledge, financial constrains and both limited health facilities and screening programmes [ 22 , 27 , 37 ].…”

Section: Discussionmentioning

confidence: 99%

Clinicopathological characteristics of breast cancer patients from Northern Tanzania: common aspects of late stage presentation and triple negative breast cancer

Gnanamuttupulle¹,

Henke²,

Ntundu³

et al. 2021

ecancer

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Purpose: Breast cancer (BC) is the second most common cancer among Tanzanian women. Oestrogen (ER), progesterone and human epidermal growth factor receptor 2 play major roles in prognosis and treatment but data for Tanzania are sparse. This study aimed to determine these patterns and histological types, tumour grading and staging of BC patients in northern Tanzania for a better understanding of BC in the Sub-Saharan African (SSA) setting. Methods:A cross-sectional study recorded newly diagnosed BC cases at Kilimanjaro Christian Medical Centre between October 2018 and March 2019. Receptor status, histological types and grade, clinical stage and socio-demographic were recorded and descriptive and bivariate analyses performed.Results: 116 patients were enrolled. Median age was 53 years, 71.6% were ≥45 years. The commonest molecular subtype was triple negative breast cancer (TNBC) (n = 33; 28.4%). One hundred and two (87.9%) patients had invasive ductal carcinoma (IDC), poorly differentiated tumours (60; 51.7%) and clinical stage III disease (62; 53.0%). ER negative tumours were associated with poorly differentiated histological grade (relative risk (RR): 1.34 (0.87-2.07)), tumour size > 5 cm (RR: 1.67 (0.33-8.35)) and IDC (RR: 3.35 (0.56-20.23)). Clinical stages III & IV (odds ratio (OR): 1.64 (0.63-4.24)) were associated with hormone receptor (HR) negative tumours and metastasis (OR: 1.60 (0.68-3.74)) with TNBC. 18% of the patients reported about first-degree relatives with BC.Conclusions: Most patients presented in advanced stages and TNBC in their menopause. HR negative tumours were associated with poor histological differentiation and IDC. The high percentage of positive family history of BC and the differences in receptor patterns compared to other parts of the world should urge further genetic research on BC in SSA.

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Section: Discussionmentioning

confidence: 99%

Clinicopathological characteristics of breast cancer patients from Northern Tanzania: common aspects of late stage presentation and triple negative breast cancer

Gnanamuttupulle¹,

Henke²,

Ntundu³

et al. 2021

ecancer

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“…The median number of children was 2 with an interquartile range of 2–3 children. The participants had a median duration of 12 ( 7 – 14 , 22 ) years since being confirmed HIV positive with the majority [200 (61.2%)] having had at least 10 years since being confirmed HIV positive. The median duration on ART use was 9 ( 5 – 12 , 22 ) years, with most of them [286 (87.5%)] being women still on first-line treatment ( Table 1 ).…”

Section: Resultsmentioning

confidence: 99%

“…The belief that pap smear is painful further contributes to poor participation in CC screening ( 13 ). Lack of knowledge among WLHIV hinders CC prevention and treatment ( 14 , 15 ). The knowledge gap in late-stage presentation is among the factors behind the high mortality rate in low- and middle-income countries (LMICs) ( 16 ).…”

Section: Introductionmentioning

confidence: 99%

Cervical cancer in Northern Tanzania—What do women living with HIV know

Mrema

Ngocho²,

Mremi³

et al. 2023

Front. Oncol.

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BackgroundCervical cancer (CC) is more prevalent in women living with human immunodeficiency virus (HIV) infection compared to the general population. The magnitude is high among all countries burdened with HIV—Tanzania is no exception. Despite the unprecedented risk, women living with HIV (WLHIV) may not be aware of the risk and might have unfounded beliefs thereof. This study aimed to determine the knowledge, awareness, and beliefs on CC screening among WLHIV attending a clinic at the Kilimanjaro Christian Medical Centre (KCMC) in Northern Tanzania.MethodsThis hospital-based cross-sectional study was conducted among 327 WLHIV attending care and treatment clinic (CTC) at KCMC. A pre-tested questionnaire was used to collect quantitative data. Both descriptive and regression methods were used to determine CC knowledge, awareness, and beliefs as well as factors associated with knowledge of CC among WLHIV using SPSS version 23.ResultsParticipants’ mean age was 46 ± 10.4 years. Although just half (54.7%) of WLHIV had insufficient knowledge of CC, the majority of the participants (83.5%) were able to recognize at least three risk factors, but with limited understanding of symptoms and prevention. The majority held positive beliefs on CC and screening practices. Factors associated with good knowledge of CC included being married (AOR: 3.66, 95% CI: 1.84–7.28), having used ART for at least 2 years (AOR: 4.08, 95% CI: 1.36–12.21), and having previously screened for CC (AOR: 1.62, 95% CI: 1.01–2.59).ConclusionWLHIV attending care and treatment center had insufficient knowledge about CC screening. To further improve screening and treatment for CC, at both facility and community levels, targeted awareness and education campaigns are warranted.

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“…CHWs provide vital care to patients in their communities and are trained to monitor symptoms, advise holistically on palliative care and are often the first point of contact for patients with cancer in the community. 11 …”

Section: Introductionmentioning

confidence: 99%

Impact of COVID-19 on delivery of oncology services in Northern Tanzania: a cross-sectional study of community health workers and patients undergoing cancer treatment at the Kilimanjaro Christian Medical Centre

et al. 2023

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ObjectiveTo ascertain how the COVID-19 pandemic was perceived by oncology patients and community health workers (CHWs) and whether this contributed to disruptions in cancer care.DesignCross-sectional study using (1) structured telephone interviews with patients and (2) structured questionnaires completed by CHWs.SettingOutpatient and community care at Kilimanjaro Christian Medical Centre’s Cancer Care Centre (KCMCCCC), Northern Tanzania.Participants300 oncology patients (158 men and 142 women) who had attended KCMCCCC between January and April 2020 and 78 CHWs (16 men and 62 women) in the KCMC regional palliative care network who conducted home visits to patients with cancer during the period January to April 2020.Primary outcome measuresFor patients, missed appointments and fear of COVID-19 more than postponement of their treatment. For CHWs, no primary outcome (a broad range of questions on perception of the pandemic were asked).Results30% of patients said they missed appointments due to the pandemic, the most commonly cited reasons being financial problems (37%) and fear of acquiring COVID-19 infection during travel and/or in the hospital (37%). Only 12.7% of patients said they feared COVID-19 more than postponement of cancer treatment. 88% of CHWs noticed differences in delivering home care since the start of the pandemic, with 58% saying they had noticed more patients dying and 74% saying that more patients were relying on local healers. 31% of CHWs said they feared home visits because of COVID-19 and 46% perceived patients feared home visits due to COVID-19. However, 92% felt home visits should continue.ConclusionThese results indicated that while there was a significant degree of disruption and fear around the COVID-19 pandemic, the majority of patients and CHWs did not fear of COVID-19 more than disruption to cancer care. This highlights the importance to these groups of maintaining access to vital cancer services.

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Repetitive Cancer Training for Community Healthcare Workers: an Effective Method to Strengthen Knowledge and Impact on the Communities: Results from a Pilot Training at Kilimanjaro Region, Tanzania

Cited by 6 publications

References 16 publications

Clinicopathological characteristics of breast cancer patients from Northern Tanzania: common aspects of late stage presentation and triple negative breast cancer

Clinicopathological characteristics of breast cancer patients from Northern Tanzania: common aspects of late stage presentation and triple negative breast cancer

Cervical cancer in Northern Tanzania—What do women living with HIV know

Impact of COVID-19 on delivery of oncology services in Northern Tanzania: a cross-sectional study of community health workers and patients undergoing cancer treatment at the Kilimanjaro Christian Medical Centre

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