Hematological malignancies in East Africa-Which cancers to expect and how to provide services.

BACKGROUND:Sub-Saharan Africa (SSA) has an increasing non-communicable disease burden. Tanzania has an incidence of more than 35,000 cancer cases per year with an 80% mortality rate. Hematological malignancies account for 10% of these cases. The numbers will double within the next 10 years due to de...

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Main Authors: Steven Alan Leak, Lilian Gasper Mmbaga, Elifuraha Wilson Mkwizu, Priscus John Mapendo, Oliver Henke
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2020-01-01
Series:PLoS ONE
Online Access:https://doi.org/10.1371/journal.pone.0232848
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spelling doaj-edbc8a3728eb453092e3052c03f09e022021-03-03T21:47:44ZengPublic Library of Science (PLoS)PLoS ONE1932-62032020-01-01155e023284810.1371/journal.pone.0232848Hematological malignancies in East Africa-Which cancers to expect and how to provide services.Steven Alan LeakLilian Gasper MmbagaElifuraha Wilson MkwizuPriscus John MapendoOliver HenkeBACKGROUND:Sub-Saharan Africa (SSA) has an increasing non-communicable disease burden. Tanzania has an incidence of more than 35,000 cancer cases per year with an 80% mortality rate. Hematological malignancies account for 10% of these cases. The numbers will double within the next 10 years due to demographic changes, better diagnostic capabilities and life style changes. Kilimanjaro Christian Medical Centre established a Cancer Care Centre (CCC) in December 2016 for a catchment area of 15 million people in Northern Tanzania. This article aims to display the hematological diagnosis and characteristics of the patients as well as to describe the advancements of hematologic services in a low resource setting. METHODS:A cross-sectional analysis of all hematological malignancies at CCC from December 2016 to May 2019 was performed and a narrative report provides information about diagnostic means, treatment and the use of synergies. RESULTS:A total of 209 cases have been documented, the most common malignancies were NHL and MM with 44% and 20%. 36% of NHL cases, 16% of MM cases and 63% of CML cases were seen in patients under the age of 45. When subcategorized, CLL/SLL cases had a median age was 56.5, 51 years for those with other entities of NHL. Sexes were almost equally balanced in all NHL groups while clear male predominance was found in HL and CML. DISCUSSION:Malignancies occur at a younger age and higher stages than in Western countries. It can be assumed that infections play a key role herein. Closing the gap of hematologic services in SSA can be achieved by adapting and reshaping existing infrastructure and partnering with international organizations.https://doi.org/10.1371/journal.pone.0232848
collection DOAJ
language English
format Article
sources DOAJ
author Steven Alan Leak
Lilian Gasper Mmbaga
Elifuraha Wilson Mkwizu
Priscus John Mapendo
Oliver Henke
spellingShingle Steven Alan Leak
Lilian Gasper Mmbaga
Elifuraha Wilson Mkwizu
Priscus John Mapendo
Oliver Henke
Hematological malignancies in East Africa-Which cancers to expect and how to provide services.
PLoS ONE
author_facet Steven Alan Leak
Lilian Gasper Mmbaga
Elifuraha Wilson Mkwizu
Priscus John Mapendo
Oliver Henke
author_sort Steven Alan Leak
title Hematological malignancies in East Africa-Which cancers to expect and how to provide services.
title_short Hematological malignancies in East Africa-Which cancers to expect and how to provide services.
title_full Hematological malignancies in East Africa-Which cancers to expect and how to provide services.
title_fullStr Hematological malignancies in East Africa-Which cancers to expect and how to provide services.
title_full_unstemmed Hematological malignancies in East Africa-Which cancers to expect and how to provide services.
title_sort hematological malignancies in east africa-which cancers to expect and how to provide services.
publisher Public Library of Science (PLoS)
series PLoS ONE
issn 1932-6203
publishDate 2020-01-01
description BACKGROUND:Sub-Saharan Africa (SSA) has an increasing non-communicable disease burden. Tanzania has an incidence of more than 35,000 cancer cases per year with an 80% mortality rate. Hematological malignancies account for 10% of these cases. The numbers will double within the next 10 years due to demographic changes, better diagnostic capabilities and life style changes. Kilimanjaro Christian Medical Centre established a Cancer Care Centre (CCC) in December 2016 for a catchment area of 15 million people in Northern Tanzania. This article aims to display the hematological diagnosis and characteristics of the patients as well as to describe the advancements of hematologic services in a low resource setting. METHODS:A cross-sectional analysis of all hematological malignancies at CCC from December 2016 to May 2019 was performed and a narrative report provides information about diagnostic means, treatment and the use of synergies. RESULTS:A total of 209 cases have been documented, the most common malignancies were NHL and MM with 44% and 20%. 36% of NHL cases, 16% of MM cases and 63% of CML cases were seen in patients under the age of 45. When subcategorized, CLL/SLL cases had a median age was 56.5, 51 years for those with other entities of NHL. Sexes were almost equally balanced in all NHL groups while clear male predominance was found in HL and CML. DISCUSSION:Malignancies occur at a younger age and higher stages than in Western countries. It can be assumed that infections play a key role herein. Closing the gap of hematologic services in SSA can be achieved by adapting and reshaping existing infrastructure and partnering with international organizations.
url https://doi.org/10.1371/journal.pone.0232848
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