Description
- Abstract:
- Introduction: Cervical cancer cases are increasing in Sub-Saharan Africa, particularly in Kenya, exacerbated by inadequate histopathology resources, posing a significant barrier to proper diagnosis and treatment. There’s been little research on the association between the evolution of histopathology resources and the diagnosis of cervical cancer. This study assessed this association at Moi Teaching and Referral Hospital in Kenya between 2018 and 2022. Methods: We used a mixed-methods approach. An in-depth interview was done with one of MTRH’s pathology laboratory staff to assess equipment, personnel, and quality control trends between 2018 and 2022. A thematic analysis was conducted in NVivo. We also conducted a comprehensive inventory review of the laboratory resources and a retrospective cross-sectional study of cervical cancer patients' medical records from 2018-2022 (n=1214) by census sampling. Microsoft Excel and Stata V17 were utilized for descriptive statistical analysis. Turnaround time (TAT) was assessed against the UK’s National Health Service Cervical Screening Program guidelines. Results: Patient annual visits at MTRH increased from ~350,000 to ~500,000 (2018-2022), during which the facility added two pathologists, one records person, and one office administrator. The histopathology personnel-to-population ratio decreased from 1.5 pathologists and 2.7 histo-technicians per 100,000 in 2018 to 1.4 pathologists and 1.8 histo-technicians per 100,000 in 2022. Despite this decrease, critical lab equipment were added in 2020 and 2022, and an average 14-day turnaround time was maintained for pathology reports. Subsequently, cervical cancer cases increased, especially among late-stage patients, over the years. Conclusion: Increasing cervical cancer diagnosis trends, despite a decreased personnel-to-patient ratio, mirrors the operational commitment of the existing workforce. The 14-day TAT is commendable and contributes significantly to operational effectiveness and patient satisfaction. However, the decline in the personnel-to-patient ratio underscores diagnosis challenges, emphasizing the need to address workforce and infrastructure gaps to improve patient care within similar LMIC settings.
- Notes:
- Thesis (M. P. H.)--Brown University, 2024
Citation
Anangwe, Nelson,
"ASSOCIATION OF PATHOLOGY RESOURCES ON CERVICAL CANCER STAGING TRENDS BETWEEN 2018 & 2022: A RETROSPECTIVE STUDY AT MOI TEACHING AND REFERRAL HOSPITAL, WESTERN KENYA"
(2024).
Public Health Theses and Dissertations.
Brown Digital Repository. Brown University Library.
https://repository.library.brown.edu/studio/item/bdr:qqce9m22/
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Public Health Theses and Dissertations
Theses and Dissertations for the Public Health department....