The Diagnostic Challenges, Possible Etiologies and Lack of Researches of Hepatocellular Carcinoma in Somalia

Abstract

Globally, hepatocellular carcinoma is the second amongst all causes of cancer deaths and it is one of the common malignancies in both developing and developed countries. The causes are variety all of the world ranging from geography, life style and advanced medical care that is available in those countries either developing such as Somalia or developed countries. Somali contributes to global burden of hepatitis B which is a known risk factor for HCC and has categorized to the world a part of high prevalence of hepatitis B which is greater than 10%, while there is no more available data of hepatitis C in Somalia that contributes the world. Diagnoses of hepatocellular carcinoma are now forward in many countries of developed world, but reality are different from developing countries such as Somalia which is now out for civil war and has a lack of medical experts in all fields of medicine such as physician, surgeons, pathologists, radiologists and the experts of the laboratory field, even if we have these medical personal who are few or they are elder than above 60 years old plus medical equipment (such as imaging and laboratory equipment). All these challenges, the author of this manuscript has faith in the diagnosis of hepatocellular carcinoma that can be rationally made to consider the clinical presentation of this disorder and to maximize use of offered diagnostic tools and to refer the few medical experts in the country.

A Retrospective Evaluation of Patients Hospitalized in the Internal Medicine Department at the Turkey Recep Tayyip Erdogan Somalia Mogadishu Training and Research Hospital

“…Limited access to modern laboratory facilities creates significant screening and diagnostic challenges for viral hepatitis cases. 17 A study (1992) on the prevalence of serological markers for HBV and HCV in 596 children in a residential institution in Somalia reported a prevalence of 16% for HBsAg and 1.5% for anti-HCV. [15][16][17][18] In another study conducted with 62 Somalian patients with chronic liver disease, including primary HCC, prevalence rates were reported as 37.1% for HBsAg and as 40.3% for anti-HCV.…”

“…17 A study (1992) on the prevalence of serological markers for HBV and HCV in 596 children in a residential institution in Somalia reported a prevalence of 16% for HBsAg and 1.5% for anti-HCV. [15][16][17][18] In another study conducted with 62 Somalian patients with chronic liver disease, including primary HCC, prevalence rates were reported as 37.1% for HBsAg and as 40.3% for anti-HCV. 19,20 While these patients probably do not need virus suppressing medications, they will still need training on transmission, continuous monitoring for progression to cirrhosis, and HCC screening.…”

Assessment of knowledge, attitude and practice of healthcare workers towards Hepatitis B virus infection in Mogadishu, Somalia: A Cross-Sectional Study

“…Although there were some reports on the prevalence of HBV in Somalia in the past [14][15][16][17][18] there is limited recent literature on the prevalence of HBV infection in Somalia. The country is among the endemic areas with high prevalence of HBV infection [19].…”

Epidemiology of viral hepatitis in Somalia: Systematic review and meta-analysis study

“…There are several studies of the prevalence of HAV, HBV, HCV, HDV, and HEV in Somalia; however, to the best of our knowledge, there is no meta-analysis to provide an overall estimation of the prevalence of all viral hepatitis infections in this country. A recent report explored the reasons for such a dearth of data[ 4 ]. In Somalia, largely due to the unsettling decades-long civil war, medical staffs are underqualified and undertrained, and limited access to modern laboratory facilities poses substantial diagnostic challenges[ 4 ].…”

“…A recent report explored the reasons for such a dearth of data[ 4 ]. In Somalia, largely due to the unsettling decades-long civil war, medical staffs are underqualified and undertrained, and limited access to modern laboratory facilities poses substantial diagnostic challenges[ 4 ]. Somalia is considered to be a country that has no national strategy for the surveillance, prevention and control of viral hepatitis[ 5 ].…”