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Ayubi E, Khazaei S. Global socioeconomic inequality in burden of five common cancers in 2019: concentration index and decomposition analysis. J Public Health (Oxf) 2023. [DOI: 10.1007/s10389-023-01889-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/30/2023] Open
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Tulsidás S, Fontes F, Brandão M, Lunet N, Carrilho C. Oncology in Mozambique: Overview of the Diagnostic, Treatment, and Research Capacity. Cancers (Basel) 2023; 15:cancers15041163. [PMID: 36831505 PMCID: PMC9953997 DOI: 10.3390/cancers15041163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 01/30/2023] [Accepted: 02/07/2023] [Indexed: 02/15/2023] Open
Abstract
Mozambique is one of the poorest countries worldwide, with nearly two thirds of the population living below the poverty line. Similarly to other less developed countries, there is a weak provision of health care for non-communicable diseases due to competing priorities with infectious diseases. Although the leading causes of death in Mozambique in 2019 were Acquired Immune Deficiency Syndrome/Human Immunodeficiency Virus and other sexually transmitted diseases and respiratory infections and tuberculosis, with increasing urbanization and westernization of lifestyles, deaths attributed to cancer are also on the rise. This review summarizes cancer burden, cancer prevention and screening, cancer care resources, and trends in cancer training and research in Mozambique, providing a background for the development of cancer care policies in the country.
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Affiliation(s)
- Satish Tulsidás
- Serviço de Oncologia Médica, Hospital Central de Maputo, nº 1653 Avenida Eduardo Mondlane, Maputo 1101, Mozambique
- EPIUnit–Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas, n° 135, 4050-600 Porto, Portugal
- Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Universidade do Porto, Rua das Taipas, n° 135, 4050-600 Porto, Portugal
| | - Filipa Fontes
- EPIUnit–Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas, n° 135, 4050-600 Porto, Portugal
- Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Universidade do Porto, Rua das Taipas, n° 135, 4050-600 Porto, Portugal
- Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina da Universidade do Porto, Rua Doutor Plácido da Costa, 4200-450 Porto, Portugal
- Unidade de Investigação em Enfermagem Oncológica, Centro de Investigação do Instituto Português de Oncologia do Porto, Rua Dr António Bernardino de Almeida, 4200-072 Porto, Portugal
| | - Mariana Brandão
- EPIUnit–Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas, n° 135, 4050-600 Porto, Portugal
- Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Universidade do Porto, Rua das Taipas, n° 135, 4050-600 Porto, Portugal
- Department of Medical Oncology, Institut Jules Bordet, Université Libre de Bruxelles, Rue Meylemeersch 90, 1070 Anderlecht, Belgium
| | - Nuno Lunet
- EPIUnit–Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas, n° 135, 4050-600 Porto, Portugal
- Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Universidade do Porto, Rua das Taipas, n° 135, 4050-600 Porto, Portugal
- Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina da Universidade do Porto, Rua Doutor Plácido da Costa, 4200-450 Porto, Portugal
| | - Carla Carrilho
- Departamento de Patologia, Faculdade de Medicina, Universidade Eduardo Mondlane, Avenida Salvador Allende, nº 702, Maputo 1101, Mozambique
- Serviço de Anatomia Patológica, Hospital Central de Maputo, Avenida Eduardo Mondlane, nº 1653, Maputo 1101, Mozambique
- Correspondence: ; Tel.: +258-823055650
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Kostova DA, Moolenaar RL, Van Vliet G, Lasu A, Mahar M, Richter P. Strengthening Pandemic Preparedness Through Noncommunicable Disease Strategies. Prev Chronic Dis 2021; 18:E93. [PMID: 34672923 PMCID: PMC8588872 DOI: 10.5888/pcd18.210237] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Affiliation(s)
- Deliana A Kostova
- Division of Global Health Protection, Centers for Disease Control and Prevention, 1600 Clifton Rd, Atlanta, GA 30322.
| | - Ronald L Moolenaar
- Division of Global Health Protection, Centers for Disease Control and Prevention, 1600 Clifton Rd, Atlanta, Georgia
| | | | - Ally Lasu
- RTI International, Research Triangle Park, North Carolina
| | - Michael Mahar
- Division of Global Health Protection, Centers for Disease Control and Prevention, 1600 Clifton Rd, Atlanta, Georgia
| | - Patricia Richter
- Division of Global Health Protection, Centers for Disease Control and Prevention, 1600 Clifton Rd, Atlanta, Georgia
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Ismail MR, Noormahomed EV, Lawicki S, Eichbaum Q. Survey of Clinical and Anatomic Pathology Laboratory Infrastructure in Mozambique. Am J Clin Pathol 2021; 156:810-817. [PMID: 33940599 DOI: 10.1093/ajcp/aqab026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES Pathology services are limited in most areas of sub-Saharan Africa. This study's aim was to survey anatomic and clinical pathology services and laboratory infrastructure in Mozambique. METHODS A survey was conducted from October-December 2018 across the four central hospitals of Mozambique to determine infrastructure and pathology services available. RESULTS Most laboratory/pathology services in Mozambique are limited to the four central hospitals. Only 14 pathologists practice in the country despite a population of 29.5 million for the world's fifth worst workforce/population ratio. Approximately 35,000 anatomic pathology specimens are evaluated annually. Standard services across chemistry, hematology, microbiology, and blood bank are available at the four central hospitals. Esoteric laboratory testing and immunohistochemistry are generally only available in Maputo. CONCLUSIONS While most pathology services are available in Mozambique, many are available only at the Maputo laboratory. Expansion of pathology services and infrastructure will improve provision of effective and efficient health care as access to timely and accurate clinical diagnoses increases in Mozambique.
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Affiliation(s)
- Mamudo R Ismail
- Pathology Department, Faculty of Medicine, Eduardo Mondlane University, Central Hospital of Maputo, Maputo, Mozambique
| | - Emília V Noormahomed
- Department of Microbiology, Faculty of Medicine, Eduardo Mondlane University, Maputo, Mozambique
- Department of Medicine, Infectious Disease Division, University of California, San Diego, CA, USA
- Mozambique Institute for Health Education and Research (MIHER), Maputo, Mozambique
| | - Shaun Lawicki
- Department of Pathology, Louisiana State University School of Medicine, Baton Rouge, LA, USA
- Department of Pathology, University Medical Center New Orleans, New Orleans, LA, USA
| | - Quentin Eichbaum
- Department of Pathology, Microbiology, and Immunology, Vanderbilt University School of Medicine, Nashville, TN, USA
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Morais A, Simão M, Cossa M, Come J, Selemane C, Tivane A, Tulsidás S, Lorenzoni C, Rodrigues J, Antunes L, Brito D, Costa MJ, Sidat M, Martins MDRO, Santos LL. Designing a National Curriculum to Advance Surgical Oncology in Mozambique: A Delphi Consensus Study. JOURNAL OF SURGICAL EDUCATION 2021; 78:140-147. [PMID: 32646814 DOI: 10.1016/j.jsurg.2020.06.030] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Revised: 05/06/2020] [Accepted: 06/25/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVE Mozambique is currently experiencing an increase in chronic diseases including cancer. There is a large unmet need for cancer surgery in Mozambique. The aim of this study was to define the content and the design of a training program for practicing surgeons in surgical oncology that would be consensually regarded as adequate to care for oncological patients requiring surgical interventions. DESIGN & SETTING A 3-round modified-Delphi approach was implemented to obtain consensus on surgical oncology training curriculum. The participants were purposefully selected experts in surgical oncology working in Mozambique. In round 1, participants answered a questionnaire with open-ended questions regarding the content of the curriculum and the timing and venue of training. In round 2, answers from the first round were presented to a purposeful selected sample of nationally recognized experts in oncology and surgical oncology, including members of the Mozambican College of Surgeons and leadership of the Ministry of Health. A final round was carried out to discuss the draft version of the training program aiming to achieve a predetermined consensus level of 80%. PARTICIPANTS Fifteen of 23 experts (65.2%) responded to round one.The response rate for round 1 and 3 was 80% (12 of the 15 participants in round one). RESULTS The responses collected in the first round were analyzed and revealed that basic principles of oncology and basic principles of surgical oncology should be included in the curriculum of surgical residency in Mozambique (80% of the experts agree; Cronbach α = 0.93); a 24-months fellowship in surgical oncology should take place after residency in the surgical field (86.6% of experts agree; Cronbach α = 0.97); and should occur at Maputo Central Hospital and at comprehensive cancer centers abroad (100% agree). In round 2 the proposal for the program of surgical oncology fellowship obtained a strong agreement amongst the experts (97.3%). The final proposal for the program was divided into the following structure: (1) theoretical components; (2) duration; (3) location; (4) methodology; (5) technical skills in oncology; and (6) competency and paid particular attention to the oncological diseases prevalent in Mozambique. The agreement amongst the experts was 97.3%. CONCLUSIONS The experts reached a consensus regarding the general structure for a cancer surgery postgraduate training program in Mozambique, which should be a 24-months fellowship after residency in surgical disciplines. This fellowship should mostly take place in Mozambique, but it should also include dedicated internships in recognized cancer hospitals abroad. Such curricula embrace the Global Curriculum in Surgical Oncology including in particular the oncological nosology of Mozambique and should advance the quality of oncology surgical care provided in the country.
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Affiliation(s)
- Atílio Morais
- Department of Surgery, University Eduardo Mondlane, Thoracic Surgery, Surgical Department, Maputo Central Hospital, Maputo , Mozambique
| | - Manuel Simão
- College of surgeons, Mozambican Medical Association, Maputo, Mozambique
| | - Matchecane Cossa
- Department of Surgery, University Eduardo Mondlane, Thoracic Surgery, Surgical Department, Maputo Central Hospital, Maputo , Mozambique
| | - Jotamo Come
- Life and Health Sciences Research Institute, School of Medicine, University of Minho, Braga, Portugal
| | - Carlos Selemane
- Colorectal Surgery, Surgical Department, Maputo Central Hospital,Maputo, Mozambique
| | - Adriano Tivane
- Department of Surgery, University Eduardo Mondlane, Thoracic Surgery, Surgical Department, Maputo Central Hospital, Maputo , Mozambique
| | - Satish Tulsidás
- Medical Oncology Department, Maputo Central Hospital, Maputo, Mozambique
| | - Cesaltina Lorenzoni
- Department of Pathology, Maputo Central Hospital, Maputo, Mozambique, Faculty of Medicine, Eduardo Mondlane University, Maputo, Mozambique
| | - Jéssica Rodrigues
- Cancer Epidemiology Group, IPO Porto Research Center (CI-IPOP), Portuguese Oncology Institute of Porto (IPO Porto), Porto, Portugal
| | - Luís Antunes
- Cancer Epidemiology Group, IPO Porto Research Center (CI-IPOP), Portuguese Oncology Institute of Porto (IPO Porto), Porto, Portugal
| | - Donzilia Brito
- Surgical Oncology Department, Portuguese Institute of Oncology, Porto, Portugal; European Union of Medical Specialists (UEMS) of Portuguese College of General Surgery
| | - Manuel João Costa
- Medical Education Unit, School of Medicine University of Minho, Portugal
| | - Moshin Sidat
- Department of Community Health, University Eduardo Mondlane, Maputo, Mozambique
| | - Maria do Rosário O Martins
- Global Health and Tropical Medicine, Institute of Hygiene and Tropical Medicine, Universidade Nova de Lisboa, Lisboa, Portugal
| | - Lúcio Lara Santos
- Surgical Oncology Department, Portuguese Institute of Oncology, Porto, Portugal; Experimental Pathology and Therapeutics Research Group, Surgical Oncology Department, Portuguese Institute of Oncology, Porto, Portugal; ONCOCIR-Education and Care in Oncology-Lusophone Africa, Moreira da Maia, Portugal.
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Lorenzoni CF, Ferro J, Carrilho C, Colombet M, Parkin DM. Cancer in Mozambique: Results from two population-based cancer registries. Int J Cancer 2020; 147:1629-1637. [PMID: 32142162 DOI: 10.1002/ijc.32953] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Revised: 02/06/2020] [Accepted: 02/14/2020] [Indexed: 01/24/2023]
Abstract
Results from two recently established population-based registries in Mozambique are reported: Beira in the central region (2014-2017) and Maputo, the capital city, in the South (2015-2017). The results are compared to those from Maputo (Lourenço Marques at the time) in 1956-1960 (appearing Cancer Incidence in Five Continents Vol 1), and with estimated incidence rates from other regions of Africa. The elevated prevalence of HIV infection (12.6% of adults in 2018) results in high rates for HIV-related cancers, and the greater prevalence in central Mozambique, compared to the south, largely explains the rather higher rates of Kaposi sarcoma (males), non-Hodgkin lymphoma, squamous cell carcinoma of conjunctiva and cervical cancer in Beira than in Maputo. Burkitt lymphoma is the commonest childhood cancer in Beira, with high rates typical of East Africa, while the low rates in Maputo are more typical of Southern Africa. Overall, 44% of cancers in Maputo and 52% in Beira are estimated to be caused by infectious agents. In the last 60 years, cancers more frequent in developed countries, such as breast and prostate, are emerging in Mozambique. The incidence of the former in Maputo has increased fivefold since 1956-1960, that of prostate cancer 2.5-fold, and that of large bowel cancer doubled. The results reported here were used to make national estimates of incidence, mortality and prevalence in Globocan 2018. The two registries were important in providing data to establish priority actions in the National Cancer Control Plan, and are a valuable resource to monitor progress toward its goals.
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Affiliation(s)
- Cesaltina F Lorenzoni
- Department of Pathology, Faculty of Medicine, Eduardo Mondlane University, Maputo Central Hospital, Maputo, Mozambique
| | - Josefo Ferro
- Department of Pathology, Hospital Central da Beira, Beira, Mozambique
| | - Carla Carrilho
- Department of Pathology, Faculty of Medicine, Eduardo Mondlane University, Maputo Central Hospital, Maputo, Mozambique
| | - Murielle Colombet
- Section of Cancer Information, International Agency for Research on Cancer, Lyon, France
| | - Donald M Parkin
- Section of Cancer Information, International Agency for Research on Cancer, Lyon, France
- Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
- African Cancer Registry Network, Oxford, United Kingdom
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Pollack EB, Mollura DR, Chong A, Harvey SC, Scheel JR. A Global Perspective on Screening. JOURNAL OF BREAST IMAGING 2020; 2:296-303. [PMID: 38424966 DOI: 10.1093/jbi/wbaa047] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Indexed: 03/02/2024]
Abstract
Breast cancer is emerging as a major global public health problem. Incidence and mortality continues to rise in low- and middle-income countries (LMICs). A significant and growing disparity exists between high-income countries and LMICs in the availability of screening services and associated preventable mortality. However, population imaging-based screening programs are not appropriate for all settings. Planners should perform a thorough assessment of the target setting prior to implementing any breast cancer detection program, as appropriate guidelines vary according to the resources available. Financial, social, and cultural barriers to breast cancer care need to be addressed to sustainably improve the morbidity and mortality of the populations and make efficient use of available services. Creative approaches, such as mobile and portable imaging and bundling of services, can facilitate the installation of early breast cancer detection programs in LMICs. While image-based screening programs are not initially resource-appropriate in many LMICs, planners can work towards this goal as part of their comprehensive breast cancer detection strategy.
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Affiliation(s)
- Erica B Pollack
- Denver Health and Hospital Authority, Department of Radiology, Denver, CO
- RAD-AID International, Chevy Chase, MD
| | | | - Alice Chong
- RAD-AID International, Chevy Chase, MD
- University of California San Diego, Department of Radiology, San Diego, CA
| | - Susan C Harvey
- RAD-AID International, Chevy Chase, MD
- Hologic Inc., Department of Breast and Skeletal Health, Danbury, CT
| | - John R Scheel
- RAD-AID International, Chevy Chase, MD
- University of Washington, Department of Radiology, Seattle, WA
- University of Washington, Department of Global Health, Seattle, WA
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Morais A, Come J, Selemane C, Pires G, Tivane A, Cossa M, Tulsidás S, Antunes L, Costa MJ, Sidat M, Martins MDR, Carrilho C, Santos LL. Understanding the bricks to build better surgical oncology unit at Maputo Central Hospital: prevalent surgical cancers and residents knowledge. Pan Afr Med J 2019; 32:83. [PMID: 31223374 PMCID: PMC6560991 DOI: 10.11604/pamj.2019.32.83.18126] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Accepted: 01/27/2019] [Indexed: 11/11/2022] Open
Abstract
INTRODUCTION Cancer is a growing concern in Mozambique. However, the country has limited facilities and few oncologists. Surgical oncologists are an unmet need. The aim of this study was to assess residents' knowledge in prevalent cancer domains and to identify and characterize prevalent cancers treated by surgery at Maputo Central Hospital, the largest hospital in Mozambique. The expectations were that the findings shall inform the development of a comprehensive curriculum in surgical oncology fellowship fit for the Hospital. METHODS To identify and characterize prevalent cancers, we performed a retrospective analysis of individual cancer patient registries of Maputo Central Hospital (MCH), Mozambique. Information was recorded into data collection sheets and analyzed with SPSS® 21. To assess MCH residents oncologic knowledge, we invited Twenty-six junior residents (49% of all residents) of different specialties to take a 30 item multiple choice written test used elsewhere in previous studies. The test focused on the domains of Basis of oncology, Radiotherapy, Pathology, Chemotherapy, Pain management, Surgical oncology and Clinical Pathway. The test was administered anonymously and without prior notice. We analyzed the overall test and topic performance of residents. RESULTS The study covered a period of 3 years and 203 patients. The most prevalent malignant tumors treated by general and thoracic surgery in MCH cancer registry were esophageal (7%), female breast (6.5%) and colorectal cancer (2.8%). Globally these malignancies were diagnosed at an advanced stage of the disease and required a multimodal treatment. The mean percent correct score of residents was 37.3%. The dimension with the highest percent correct score were clinical management (46%) and surgical oncology (28%) showed the lowest correct score. CONCLUSION In Maputo, Mozambique esophageal, breast and colorectal cancer were the most prevalent malignancies treated, with surgery, by thoracic or general surgery in MCH. The test scores suggest that, among residents, the knowledge in oncology needs to be improved, rendering support to the need of a surgical oncology training tailored to suit the local needs. Specific training should take into account local cancer prevalence, resources, their quality and the support of surgical oncology services with volume and experience.
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Affiliation(s)
- Atílio Morais
- Surgical Department, Maputo Central Hospital, Maputo, Mozambique
- Department of Surgery of Faculty of Medicine, University of Eduardo Mondlane, Maputo, Mozambique
| | - Jotamo Come
- Surgical Department, Maputo Central Hospital, Maputo, Mozambique
| | - Carlos Selemane
- Surgical Department, Maputo Central Hospital, Maputo, Mozambique
| | - Germano Pires
- Surgical Department, Maputo Central Hospital, Maputo, Mozambique
| | - Adriano Tivane
- Surgical Department, Maputo Central Hospital, Maputo, Mozambique
| | - Matchecane Cossa
- Surgical Department, Maputo Central Hospital, Maputo, Mozambique
| | - Satish Tulsidás
- Medical Oncology Department, Maputo Central Hospital, Maputo, Mozambique
| | - Luís Antunes
- Epidemiology Service, Portuguese Institute of Oncology, Porto, Portugal
| | - Manuel João Costa
- Medical Education Unit, School of Medicine University of Minho, Portugal
| | - Moshin Sidat
- Department of Community Health, University of Eduardo Mondlane, Maputo, Mozambique
- Global Health and Tropical Medicine, Institute of Hygiene and Tropical Medicine, NOVA University of Lisbon, Portugal
| | - Maria do Rosário Martins
- Global Health and Tropical Medicine, Institute of Hygiene and Tropical Medicine, NOVA University of Lisbon, Portugal
| | - Carla Carrilho
- Pathology Department, Maputo Central Hospital, Maputo, Mozambique
| | - Lúcio Lara Santos
- Surgical Oncology Department, Portuguese Institute of Oncology, Porto, Portugal
- Experimental Pathology and Therapeutics Research Group, Portuguese Institute of Oncology, Porto, Portugal
- ONCOCIR- Education and Care in Oncology, Lusophone, Africa
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Santos LL, Spencer HB, Miguel F, Tulsidás S, Rodrigues B, Lopes LV. Fight against cancer in Portuguese-speaking African countries: echoes from the last cancer meetings. Infect Agent Cancer 2019. [PMCID: PMC6377738 DOI: 10.1186/s13027-019-0222-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Portuguese-speaking countries in Africa include Angola, Mozambique, Guinea-Bissau, Cape Verde, São Tomé and Principe. These countries belong to an interstate organization known as PALOP. In June 2018, PALOP organized a cancer meeting in Praia, Cape Verde, entitled ‘Quality in cancer care, optimization of cancer units, cancer education and training.’ This meeting was supported by faculty from the African Organization for Research and Training in Cancer (AORTIC) and was dedicated to the improvement of cancer care in PALOP countries. The burden of non-communicable diseases, which includes cancer, is increasing rapidly in these countries.. During this meeting, a plan was developed to guide the future strategic actions in this community. The main points of action include to increase access to cancer care, boost HPV and hepatitis B vaccination, improve access to cancer treatment, including radiotherapy and palliative care, amongst others. Efforts will be made to ensure the participation of all of these countries at PALOP meetings, including Equatorial Guinea, a potential new member.
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Morais A, Cossa M, Tivane A, Come J, Venetsky V, Torres F, Pacheco V, Reyes M, Pires G, Peyroteo M, Tulsidas S, Baker E, Sidat M, O Martins MDR, Santos LL. Identifying barriers and finding solutions to implement best practices for cancer surgery at Maputo Central Hospital, Mozambique. Ecancermedicalscience 2018; 12:878. [PMID: 30483358 PMCID: PMC6214672 DOI: 10.3332/ecancer.2018.878] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2018] [Indexed: 01/06/2023] Open
Abstract
Purpose The aim of this study was to assess the surgical resources and surgical oncology team skills at the Surgical Department of Maputo Central Hospital (MCH) in Mozambique in order to define an educational program to support surgical oncology practice. Methods From January 2017 to December 2017, a general evaluation of the resources of MCH was carried out, as well as its offerings in oncological care in different services. Data were obtained by reviewing documents, visiting surgical services and interviewing key-informants and others informally. In addition, a group of seven surgeons of the Surgical Department of MCH answered a questionnaire about the quality of the cancer units (The Cancer Units Assessment Checklist for low- or middle-income African countries). Subsequently, surgical, anaesthesiology and intensive care facilities were evaluated according to the Portuguese-speaking African Countries Assessment of Surgical Oncology Capacity Survey (PSAC-Surgery). All the data were triangulated in order to identify gaps, develop an action plan and define an educational program. Results Breast, oesophagus and colorectal cancers were the most commonly treated neoplasms in MCH. A range of technical and resource needs as well as the gaps in knowledge and skills were identified. All surgeons recognised the need to create a training program in oncology at the undergraduate level, specific training for residents and continuing oncological education for general surgeons to improve the practice of surgical oncology. It was evident that all these interventions needed to be formalised, appropriately certified and count for professional career progression. Based on the local epidemiological data and on these study findings, oncology education programs were developed for surgeons. Conclusions The findings of this study contributed to the development of an educational program in surgical oncology, considered essential to the training of surgeons at MCH. The cancer educational programs and the mobilisation of adequate resources will ensure the provision of adequate surgical oncology treatments for MCH. The training requirements should be tailored to suit the local needs based on the most prevalent malignancies diagnosed in the region. In our view, this methodology may apply to other countries with similar realities in the formation of surgical oncologists.
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Affiliation(s)
- Atílio Morais
- Thoracic Surgery, Surgical Department, Maputo Central Hospital, Av Agostinho Neto n° 164, Maputo 1164, Mozambique
| | - Matchecane Cossa
- Thoracic Surgery, Surgical Department, Maputo Central Hospital, Av Agostinho Neto n° 164, Maputo 1164, Mozambique
| | - Adriano Tivane
- Thoracic Surgery, Surgical Department, Maputo Central Hospital, Av Agostinho Neto n° 164, Maputo 1164, Mozambique
| | - Jotamo Come
- Breast Surgery, Surgical Department, Maputo Central Hospital, Av Agostinho Neto n° 164, Maputo 1164, Mozambique
| | - Volodimir Venetsky
- Breast Surgery, Surgical Department, Maputo Central Hospital, Av Agostinho Neto n° 164, Maputo 1164, Mozambique
| | - Fernando Torres
- Breast Surgery, Surgical Department, Maputo Central Hospital, Av Agostinho Neto n° 164, Maputo 1164, Mozambique
| | - Victor Pacheco
- Colorectal Surgery, Surgical Department, Maputo Central Hospital, Av Agostinho Neto n° 164, Maputo 1164, Mozambique
| | - Miguel Reyes
- Colorectal Surgery, Surgical Department, Maputo Central Hospital, Av Agostinho Neto n° 164, Maputo 1164, Mozambique
| | - Germano Pires
- Heath National Institute, Av Eduardo Mondlane, Maputo 264, Mozambique
| | - Mariana Peyroteo
- Surgical Oncology Department, Portuguese Institute of Oncology, Dr António Bernardino de Almeida Street, Porto 4200-072, Portugal
| | - Satish Tulsidas
- Medical Oncology Department, Maputo Central Hospital, Av Agostinho Neto n° 164, Maputo 1164, Mozambique
| | - Ellen Baker
- UT MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX 77030, USA
| | - Moshin Sidat
- Department of Community Health, University Eduardo Mondlane, Av Julius Nyerere, Maputo 257, Mozambique.,Global Health and Tropical Medicine, Institute of Hygiene and Tropical Medicine, Universidade Nova de Lisboa, Junqueira Street 100, Lisboa 1349-008 Portugal
| | - Maria do Rosário O Martins
- Global Health and Tropical Medicine, Institute of Hygiene and Tropical Medicine, Universidade Nova de Lisboa, Junqueira Street 100, Lisboa 1349-008 Portugal
| | - Lúcio Lara Santos
- Surgical Oncology Department, Portuguese Institute of Oncology, Dr António Bernardino de Almeida Street, Porto 4200-072, Portugal.,Experimental Pathology and Therapeutics Research Group, Surgical Oncology Department, Portuguese Institute of Oncology, Dr António Bernardino de Almeida Street, Porto 4200-072, Portugal.,ONCOCIR-Education and Care in Oncology-Lusophone Africa, Quires Street 168, Moreira da Maia 4470-643, Portugal
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