scholarly journals Few Losses to Follow-up in a Sub-Saharan African Cancer Cohort via Active Mobile Health Follow-up

2020 ◽  
Vol 189 (10) ◽  
pp. 1185-1196 ◽  
Author(s):  
Milena Foerster ◽  
Angelica Anele ◽  
Charles Adisa ◽  
Moses Galukande ◽  
Groesbeck Parham ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Median Time ◽  
Mobile Health ◽  
Cancer Survival ◽  
Controlled Trial ◽  
Cancer Control ◽  
Sub Saharan Africa ◽  
Next Of Kin ◽  
Sub Saharan

Abstract Accurate survival estimates are needed for guiding cancer control efforts in sub-Saharan Africa, but previous studies have been hampered by unknown biases due to excessive loss to follow-up (LTFU). In the African Breast Cancer—Disparities in Outcomes Study, a prospective breast cancer cohort study, we implemented active mobile health follow-up, telephoning each woman or her next-of-kin (NOK) trimonthly on her mobile phone to update information on her vital status. Dates of every contact with women/NOK were analyzed from diagnosis in 2014–2017 to the earliest of September 1, 2018, death, or 3 years postdiagnosis. The cumulative incidence of being LTFU was calculated considering deaths as competing events. In all, 1,490 women were followed for a median of 24.2 (interquartile range (IQR), 14.2–34.5) months, corresponding to 8,529 successful contacts (77% of total contacts) with the women/NOK. Median time between successful contacts was 3.0 (IQR, 3.0–3.7) months. In all, 71 women (5.3%) were LTFU at 3 years: 0.8% in Nigeria, 2.2% in Namibia, and 5.6% in Uganda. Because of temporary discontinuity of active follow-up, 20.3% of women were LTFU after 2 years in Zambia. The median time to study notification of a death was 9.1 (IQR, 3.9–14.0) weeks. Although the present study was not a randomized controlled trial, in this cancer cohort with active mobile health follow-up, LTFU was much lower than in previous studies and enabled estimation of up-to-date and reliable cancer survival.

scholarly journals Follow-up of Breast Cancer Patients in Ghana: Challenges to Community-based Surveillance

2015 ◽  
Vol 7 (1) ◽  
Author(s):  
Dennis O. Laryea ◽  
Baffour Awuah ◽  
Yaw A. Amoako ◽  
Samuel Mensah ◽  
Fred K. Awittor
Keyword(s):  
Breast Cancer ◽  
Cancer Control ◽  
Sub Saharan Africa ◽  
Quality Data ◽  
Cancer Registration ◽  
Breast Cancer Patients ◽  
Control Programmes ◽  
Control And Prevention ◽  
Sub Saharan

Cancer-related deaths have been projected to increase in sub-Saharan Africa. Cancer control programmes require good quality data in order to provide information for planning and implementing cancer control and prevention activities. Cancer registration and follow-up of cancer cases to estimate survival are useful tools in cancer control programmes. We followed up 136 cases of breast cancer diagnosed from the year 2006 to 2008. The majority of cases (62.5%) could not be reached either by phone or at the residential address indicated in the folders. We recommend a strengthened system of demographic information collection on cases for effective surveillance.

scholarly journals Breast cancer survival and survival gap apportionment in sub-Saharan Africa (ABC-DO): a prospective cohort study

2020 ◽  
Vol 8 (9) ◽  
pp. e1203-e1212 ◽  
Author(s):  
Valerie McCormack ◽  
Fiona McKenzie ◽  
Milena Foerster ◽  
Annelle Zietsman ◽  
Moses Galukande ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cohort Study ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Cancer Survival ◽  
Breast Cancer Survival ◽  
Sub Saharan Africa ◽  
Sub Saharan

scholarly journals Breast cancer survival in sub‐Saharan Africa by age, stage at diagnosis and human development index: A population‐based registry study

2019 ◽  
Vol 146 (5) ◽  
pp. 1208-1218 ◽  
Author(s):  
Walburga Y. Joko‐Fru ◽  
Adalberto Miranda‐Filho ◽  
Isabelle Soerjomataram ◽  
Marcel Egue ◽  
Marie‐Therese Akele‐Akpo ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Human Development Index ◽  
Cancer Survival ◽  
Population Based ◽  
Breast Cancer Survival ◽  
Sub Saharan Africa ◽  
Stage At Diagnosis ◽  
Registry Study ◽  
Sub Saharan ◽  
Population Based Registry

scholarly journals A Smartphone Game to Prevent HIV Among Young Africans: Protocol for a Randomized Pilot Study of a Mobile Intervention (Preprint)

2018 ◽  
Author(s):  
Gaëlle Sabben ◽  
Victor Akelo ◽  
Victor Mudhune ◽  
Ken Ondeng'e ◽  
Richard Ndivo ◽  
...  
Keyword(s):  
Young People ◽  
Controlled Trial ◽  
Hiv Infections ◽  
Geographic Area ◽  
Sub Saharan Africa ◽  
Hiv Prevention Intervention ◽  
Randomized Controlled ◽  
Sub Saharan ◽  
Lost To Follow Up

BACKGROUND Young people aged under 25 years make up an increasing proportion of the population in emerging economies such as Kenya, where half of new adult HIV infections are among 15- to 24-year olds. Interventions targeting this age group have the potential to avert HIV infections among an increasingly large at-risk population. Interactive communication technologies offer a promising platform for reaching young people in engaging ways. OBJECTIVE Tumaini is a narrative-based smartphone game designed to help young Africans protect themselves from HIV. The objective of this study was to pilot test the game, focusing on the data needed to inform a future randomized controlled efficacy trial, including assessments of study feasibility and safety. METHODS The study took place in Kisumu Town, western Kenya, in spring 2017. The game-based intervention was pilot tested for 16 days with a sample of 60 preadolescents aged 11 to 14 years. Participant recruitment was initiated through schools. Participants were randomly assigned to the control or intervention arms of the study. One parent for each of the intervention arm participants was also recruited (n=30). The intervention arm participants were provided with smartphones on which Tumaini was loaded so that they could play the game at home. Youth completed behavioral surveys at baseline, posttest, and 6-week follow-up. The intervention arm participants provided quantitative feedback on their experience of the game-based intervention at posttest. They and their parents further participated in postintervention focus group discussions. Feasibility-related study metrics were collected on recruitment, enrollment, attrition, safety of participants, and return of phones. RESULTS Recruitment and enrollment of the 60 preadolescents and parents were successfully completed within 18 days. No participants were lost to follow-up: all youth completed all 3 waves of the survey and 27 intervention arm youth and 22 parents and caregivers participated in the focus groups. No safety concerns were reported. All phones were returned after the intervention period; none were damaged or lost. All intervention arm participants initiated gameplay, recording a mean exposure time just under 27 hours. CONCLUSIONS Findings indicate that it is feasible and safe to test a smartphone-based HIV prevention intervention for very young adolescents in urban and peri-urban sub-Saharan Africa by initiating recruitment in schools and temporarily providing youth participants with smartphones on which the game is loaded. A randomized controlled trial powered to assess the efficacy of the game-based intervention is being designed to be carried out in the same geographic area as the pilot, using similar methods. CLINICALTRIAL ClinicalTrials.gov NCT03054051; https://clinicaltrials.gov/ct2/show/NCT03054051 (Archived by WebCite at http://www.webcitation.org/6wjwpX8Bg.) INTERNATIONAL REGISTERED REPOR RR1-10.2196/11209

scholarly journals Effect of a single dose of oral azithromycin on malaria parasitaemia in children: a randomized controlled trial

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Boubacar Coulibaly ◽  
Ali Sié ◽  
Clarisse Dah ◽  
Mamadou Bountogo ◽  
Mamadou Ouattara ◽  
...  
Keyword(s):  
Controlled Trial ◽  
Childhood Mortality ◽  
Sub Saharan Africa ◽  
Tympanic Temperature ◽  
Malaria Parasitaemia ◽  
Randomized Controlled ◽  
Sub Saharan ◽  
Oral Azithromycin ◽  
Thick Smear

Abstract Background Azithromycin has recently been shown to reduce all-cause childhood mortality in sub-Saharan Africa. One potential mechanism of this effect is via the anti-malarial effect of azithromycin, which may help treat or prevent malaria infection. This study evaluated short- and longer-term effects of azithromycin on malaria outcomes in children. Methods Children aged 8 days to 59 months were randomized in a 1:1 fashion to a single oral dose of azithromycin (20 mg/kg) or matching placebo. Children were evaluated for malaria via thin and thick smear and rapid diagnostic test (for those with tympanic temperature ≥ 37.5 °C) at baseline and 14 days and 6 months after treatment. Malaria outcomes in children receiving azithromycin versus placebo were compared at each follow-up timepoint separately. Results Of 450 children enrolled, 230 were randomized to azithromycin and 220 to placebo. Children were a median of 26 months and 51% were female, and 17% were positive for malaria parasitaemia at baseline. There was no evidence of a difference in malaria parasitaemia at 14 days or 6 months after treatment. In the azithromycin arm, 20% of children were positive for parasitaemia at 14 days compared to 17% in the placebo arm (P = 0.43) and 7.6% vs. 5.6% in the azithromycin compared to placebo arms at 6 months (P = 0.47). Conclusions Azithromycin did not affect malaria outcomes in this study, possibly due to the individually randomized nature of the trial. Trial registration This study is registered at clinicaltrials.gov (NCT03676751; registered 19 September 2018).

Breast cancer survival in rural sub-Saharan Africa

2020 ◽  
Author(s):  
Paddy Ssentongo ◽  
John Oh ◽  
Forster Amponsah ◽  
William Wong ◽  
Xavier Candela ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Overall Survival ◽  
Survival Rate ◽  
Low Income ◽  
Significant Proportion ◽  
Sub Saharan Africa ◽  
Lymph Node Status ◽  
Overall Survival Rate ◽  
Sub Saharan

Abstract INTRODUCTION: Five-year overall survival rate of breast cancer in low-income countries (LICs) is significantly lower than in high-resource countries. In this study, we explored clinical and pathological factors influencing mortality in a rural community setting in sub-Saharan Africa. METHODS: We performed a retrospective medical review of patients undergoing surgery and chemotherapy for breast cancer at a regional hospital in Ghana from January 2014 through January 2017. Descriptive and survival analysis was done. RESULTS: One hundred and twenty-nine patients were included in the study. The median age at presentation was 51 years. 60.0% of patients presented with poorly differential histological grade III. The most common histological type was invasive ductal carcinoma (83%). Based on assessment of stage using only tumor size and lymph node status, 60% presented at stage 3. Only 25% were tested for hormone receptor proteins and HER2 status. Of these, 57% had triple-negative breast cancer (TNBC). The 3-year overall survival rate was only 52%. A significant proportion of the patients (46%) were lost to follow-up. CONCLUSIONS: The cumulative 3-year survival was 52 %. Despite success in the reduction of cancer mortality in southern and northern Africa, survival in the rural communities of sub-Saharan Africa remains poor. A significantly higher percentage of GIII and TNBC is found in breast cancers seen in Ghana. Late-stage presentation, when combined with limited capacity for accurate diagnosis, cancer subtype analysis, adequate therapy and follow-up, leads to poor outcomes. Future studies should emphasize identification of barriers to care and opportunities for cost-effective and sustainable improvements in the diagnosis and treatment of breast cancer in LICs.

Sign in / Sign up

Export Citation Format

Share Document