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Cancer Care in Countries in Transition in Africa: The Case of Uganda

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Cancer Care in Countries and Societies in Transition

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Abstract

Uganda is a low-income country experiencing epidemiological transition with a double burden of communicable diseases including malaria, tuberculosis, and HIV as well as a rising incidence of noncommunicable diseases including cancers, hypertension, and heart diseases and diabetes. The country has a high population growth rate of 3.5 %. The population of the older people who are more prone to cancers is increasing exponentially and cancers related to lifestyles and old age are on the increase. This is in addition to the high rates of infection-related cancers including cervical cancer (most common cancer among women in Uganda), Kaposi sarcoma, and hepatocellular carcinoma. These infection-related cancers predominantly affect the young economically productive age groups and hence contribute negatively to economic production and poverty eradication. Majority of cancer patients in Uganda are diagnosed with advanced stage cancers and experience poor survival. There are few specialized cancer care facilities and cancer specialists in Uganda. Hospice Africa Uganda contributes immensely to the care of the terminally ill cancer patients while the Kampala Cancer registry provides high quality data on cancer exposures, incidences, and mortality to guide planning, research, and policy on care for cancer.

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References

  1. Frenk J, Bobadilla JL, Sepuulveda J, Cervantes ML. Health transition in middle-income countries: new challenges for health care. Health Policy Planning. 1989;4(1):29–39.

    Article  Google Scholar 

  2. Kiwanuka N, Ssetaala A, Nalutaaya A, Mpendo J, Wambuzi M, Nanvubya A, et al. High incidence of HIV-1 infection in a general population of fishing communities around Lake Victoria, Uganda. PLoS One. 2014;9(5):e94932.

    Article  PubMed Central  PubMed  Google Scholar 

  3. Nantongo JM, Wobudeya E, Mupere E, Joloba M, Ssengooba W, Kisembo HN, et al. High incidence of pulmonary tuberculosis in children admitted with severe pneumonia in Uganda. BMC Pediatr. 2013;13(1):16.

    Article  PubMed Central  PubMed  Google Scholar 

  4. Seeley J, Nakiyingi-Miiro J, Kamali A, Mpendo J, Asiki G, Abaasa A, et al. High HIV incidence and socio-behavioral risk patterns in fishing communities on the shores of Lake Victoria, Uganda. Sexually Transm Dis. 2012;39(6):433–9.

    Article  Google Scholar 

  5. Okiro EA, Bitira D, Mbabazi G, Mpimbaza A, Alegana VA, Talisuna AO, et al. Increasing malaria hospital admissions in Uganda between 1999 and 2009. BMC Med. 2011;9(1):37.

    Article  PubMed Central  PubMed  Google Scholar 

  6. Jagannathan P, Muhindo MK, Kakuru A, Arinaitwe E, Greenhouse B, Tappero J, et al. Increasing incidence of malaria in children despite insecticide-treated bed nets and prompt anti-malarial therapy in Tororo, Uganda. Malaria J. 2012;11:435.

    Article  Google Scholar 

  7. Mayega RW, Makumbi F, Rutebemberwa E, Peterson S, Östenson C-G, Tomson G, et al. Modifiable socio-behavioural factors associated with overweight and hypertension among persons aged 35 to 60 years in eastern Uganda. PLoS One. 2012;7(10):e47632.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  8. Mayega RW, Guwatudde D, Makumbi F, Nakwagala FN, Peterson S, Tomson G, et al. Diabetes and pre-diabetes among persons aged 35 to 60 years in eastern Uganda: prevalence and associated factors. PLoS One. 2013;8(8):e72554.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  9. Wabinga HR, Nambooze S, Amulen PM, Okello C, Mbus L, Parkin DM. Trends in the incidence of cancer in Kampala, Uganda 1991–2010. Int J Cancer. 2014;135(2):432–9. Epub 2014/03/13.

    Article  CAS  PubMed  Google Scholar 

  10. Musinguzi G, Nuwaha F. Prevalence, awareness and control of hypertension in Uganda. PLoS One. 2013;8(4):e62236.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  11. Maher D, Waswa L, Baisley K, Karabarinde A, Unwin N. Epidemiology of hypertension in low-income countries: a cross-sectional population-based survey in rural Uganda. J Hypertens. 2011;29(6):1061–8.

    Article  CAS  PubMed  Google Scholar 

  12. Parkin DM. The global health burden of infection-associated cancers in the year 2002. Int J Cancer. 2006;118(12):3030–44. Epub 2006/01/13.

    Article  CAS  PubMed  Google Scholar 

  13. Parkin D, Bray F. The burden of HPV-related cancers. Vaccine. 2006;24 Suppl 3:S3/11–25.

    Google Scholar 

  14. Kostelecky B, Trimble EL, Bhatia K. Learning lessons from cancer centers in low-and middle-income countries. Infect Agent Cancer. 2013;8(1):44.

    Article  PubMed Central  PubMed  Google Scholar 

  15. Maher D, Smeeth L, Sekajugo J. Health transition in Africa: practical policy proposals for primary care. Bull World Health Organ. 2010;88(12):943–8.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  16. Uganda Bureau of Statistics UBOS. Projections of Demographic Trends in Uganda 2007–2017. UBOS UBoS, editor: Government of Uganda; 2007.

    Google Scholar 

  17. Ministry of Health (MOH). Uganda Demographic and Health Survey (UDHS). Kampala: Government of Uganda; 2006.

    Google Scholar 

  18. Thun MJ, DeLancey JO, Center MM, Jemal A, Ward EM. The global burden of cancer: priorities for prevention. Carcinogenesis. 2010;31(1):100–10.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  19. Ferlay J, Bray F, Pisani P, Parkin DM. GLOBOCAN 2002: cancer incidence, mortality, and prevalence worldwide. Lyon: International Agency for Research on Cancer; 2003.

    Google Scholar 

  20. Ferlay J, Shin HR, Bray F, Forman D, Mathers C, Parkin DM. GLOBOCAN 2008: cancer incidence and mortality worldwide. Lyon: International Agency for Research on Cancer; 2010.

    Google Scholar 

  21. Bray F, Moller B. Predicting the future burden of cancer. Nat Rev. 2006;6(1):63–74.

    Article  CAS  Google Scholar 

  22. Savage L. Former African cancer research powerhouse makes plans for a return to greatness. J Natl Cancer Inst. 2007;99(15):1144–5. Epub 2007/07/27.

    Article  PubMed  Google Scholar 

  23. Abdel-Wahab M, Bourque JM, Pynda Y, Izewska J, Van der Merwe D, Zubizarreta E, et al. Status of radiotherapy resources in Africa: an International Atomic Energy Agency analysis. Lancet Oncol. 2013;14(4):e168–75. Epub 2013/04/09.

    Article  PubMed  Google Scholar 

  24. Davies JNP, Knowelden J, Wilson BA. Incidence rates of cancer in Kyadondo County, Uganda, 1954–1960. J Natl Cancer Inst. 1965;35(5):789–821.

    CAS  PubMed  Google Scholar 

  25. Merriman A. Going the extra mile with the bare essentials: home care in Uganda. Progr Palliative Care. 2010;18(1):18–22.

    Article  Google Scholar 

  26. Kikule E. A good death in Uganda: survey of needs for palliative care for terminally ill people in urban areas. BMJ (Clinical Research ed). 2003;327(7408):192–4.

    Article  Google Scholar 

  27. Jagwe J, Merriman A. Uganda: delivering analgesia in rural Africa: opioid availability and nurse prescribing. J Pain Symptom Manage. 2007;33(5):547–51.

    Article  PubMed  Google Scholar 

  28. Olweny CLM. The Uganda Cancer Institute. Oncology. 1980;37(5):367–70.

    Article  CAS  PubMed  Google Scholar 

  29. Adewole I, Martin DN, Williams MJ, Adebamowo C, Bhatia K, Berling C, et al. Building capacity for sustainable research programmes for cancer in Africa. Nat Rev Clin Oncol. 2014;11(5):251–9.

    Article  PubMed Central  PubMed  Google Scholar 

  30. Orem J, Wabinga H. The roles of national cancer research institutions in evolving a comprehensive cancer control program in a developing country: experience from Uganda. Oncology. 2009;77(5):272–80.

    Article  PubMed  Google Scholar 

  31. Parkin D. The role of cancer registries in cancer control. Int J Clin Oncol. 2008;13(2):102–11.

    Article  PubMed  Google Scholar 

  32. Paul T, Gautam U, Rajwanshi A, Das A, Trehan A, Malhotra P, et al. Flow cytometric immunophenotyping and cell block immunocytochemistry in the diagnosis of primary Non-Hodgkin’s Lymphoma by fine-needle aspiration: experience from a tertiary care center. J Cytol. 2014;31(3):123.

    Article  PubMed Central  PubMed  Google Scholar 

  33. Böcking A, Stockhausen J, Meyer-Ebrecht D. Towards a single cell cancer diagnosis. Multimodal and monocellular measurements of markers and morphology (5M). Analyt Cell Pathol. 2004;26(1):73–9.

    Google Scholar 

  34. Onofre ASC, Pomjanski N, Buckstegge B, Böcking A. Immunocytochemical diagnosis of hepatocellular carcinoma and identification of carcinomas of unknown primary metastatic to the liver on fine‐needle aspiration cytologies. Cancer Cytopathol. 2007;111(4):259–68.

    Article  Google Scholar 

  35. Böcking A, Nguyen VQH. Diagnostic and prognostic use of DNA image cytometry in cervical squamous intraepithelial lesions and invasive carcinoma. Cancer Cytopathol. 2004;102(1):41–54.

    Article  Google Scholar 

  36. Ogwang MD, Zhao W, Ayers LW, Mbulaiteye SM. Accuracy of Burkitt lymphoma diagnosis in constrained pathology settings: importance to epidemiology. Archiv Pathol Lab Med. 2011;135(4):445–50.

    Google Scholar 

  37. Orem J, Sandin S, Weibull CE, Odida M, Wabinga H, Mbidde E, et al. Agreement between diagnoses of childhood lymphoma assigned in Uganda and by an international reference laboratory. Clin Epidemiol. 2012;4:339.

    PubMed Central  PubMed  Google Scholar 

  38. Wittekind D. Traditional staining for routine diagnostic pathology including the role of tannic acid. 1. Value and limitations of the hematoxylin-eosin stain. Biotech Histochem. 2003;78(5):261–70.

    Article  CAS  PubMed  Google Scholar 

  39. Simpson PT, Reis-Filho JS, Lakhani SR. Breast pathology: beyond morphology. Semin Diagn Pathol. 2010;27(1):91–6.

    Article  PubMed  Google Scholar 

  40. Wabinga H, Ramanakumar AV, Banura C, Luwaga A, Nambooze S, Parkin DM. Survival of cervix cancer patients in Kampala, Uganda: 1995–1997. Br J Cancer. 2003;89(1):65–9.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  41. Gondos A, Brenner H, Wabinga H, Parkin DM. Cancer survival in Kampala, Uganda. Br J Cancer. 2005;92(9):1808–12.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  42. Coghill A, Mutyaba I, Okuku F, Phipps W, Harlan JM, Orem J, et al. Treatment recommendations for patients with NHL at the Uganda Cancer Institute. Blood. 2013;122(21):2960.

    Google Scholar 

  43. Mike M, Ronald W, Fabian N. Survival factors of Burkitt’s lymphoma patients at discharge: the case of St. Mary’s Hospital Lacor in Northern Uganda. Am J Health Res. 2014;2(1):9.

    Article  Google Scholar 

  44. Buckle GC, Collins JP, Sumba PO, Nakalema B, Omenah D, Stiffler K, et al. Factors influencing time to diagnosis and initiation of treatment of endemic Burkitt Lymphoma among children in Uganda and Western Kenya: a cross-sectional survey. Infect Agent Cancer. 2013;8(1):36.

    Article  PubMed Central  PubMed  Google Scholar 

  45. De Boer C, Niyonzima N, Orem J, Bartlett J, Zafar SY. Prognosis and delay of diagnosis among Kaposi’s sarcoma patients in Uganda: a cross-sectional study. Infect Agent Cancer. 2014;9(1):17.

    Article  PubMed Central  PubMed  Google Scholar 

  46. Gyenwali D, Khanal G, Paudel R, Amatya A, Pariyar J, Onta SR. Estimates of delays in diagnosis of cervical cancer in Nepal. BMC Womens Health. 2014;14(1):29.

    Article  PubMed Central  PubMed  Google Scholar 

  47. Gyenwali D, Pariyar J, Onta SR. Factors associated with late diagnosis of cervical cancer in Nepal. Asian Pac J Cancer Prev. 2013;14(7):4373–7.

    Article  PubMed  Google Scholar 

  48. Mwaka AD, Okello ES, Wabinga H, et al. Symptomatic presentation with cervical cancer in Uganda: a qualitative study assessing the pathways to diagnosis in a low-income country. BMC Women’s Health. 2015;15(1).

    Google Scholar 

  49. Mwaka AD, Okello ES, Orach CG. Barriers to biomedical care and use of traditional medicines for treatment of cervical cancer: an exploratory qualitative study in northern Uganda. Eur J Cancer Care. 2015;24:503–13.

    Article  CAS  Google Scholar 

  50. Mwaka AD, Wabinga HR, Mayanja-Kizza H. Mind the gaps: a qualitative study of perceptions of healthcare professionals on challenges and proposed remedies for cervical cancer help-seeking in post conflict northern Uganda. BMC Fam Pract. 2013;14:193. Epub 2013/12/18.

    Article  PubMed Central  PubMed  Google Scholar 

  51. Szczepura A. Access to health care for ethnic minority populations. Postgraduate Med J. 2005;81(953):141–7.

    Article  CAS  Google Scholar 

  52. Kagawa-Singer M, Kassim-Lakha S. A strategy to reduce cross-cultural miscommunication and increase the likelihood of improving health outcomes. Acad Med. 2003;78(6):577–87.

    Article  PubMed  Google Scholar 

  53. Igun UA. Stages in health-seeking: a descriptive model. Social Sci Med. 1979;13A(4):445–56.

    CAS  Google Scholar 

  54. Kleinman A, Eisenberg L, Good B. Culture, illness, and care: clinical lessons from anthropologic and cross-cultural research. Ann Intern Med. 1978;88(2):251–8.

    Article  CAS  PubMed  Google Scholar 

  55. Mechanic D. Social psychologic factors affecting the presentation of bodily complaints. N Engl J Med. 1972;286(21):1132–9.

    Article  CAS  PubMed  Google Scholar 

  56. Waxler NE. Culture and mental illness. A social labeling perspective. J Nerv Ment Dis. 1974;159(6):379–95.

    Article  CAS  PubMed  Google Scholar 

  57. Mwaka AD, Okello ES, Kiguli J, Rutebemberwa E. Understanding cervical cancer: an exploration of lay perceptions, beliefs and knowledge about cervical cancer among the Acholi in northern Uganda. BMC Womens Health. 2014;14(84):1472–6874.

    Google Scholar 

  58. Pud D, Kaner E, Morag A, Ben-Ami S, Yaffe A. Use of complementary and alternative medicine among cancer patients in Israel. Eur J Oncol. 2005;9(2):124–30. Epub 2005/06/10.

    Article  CAS  Google Scholar 

  59. Ku CF, Koo M. Association of distress symptoms and use of complementary medicine among patients with cancer. J Clin Nurs. 2012;21(5–6):736–44. Epub 2011/11/10.

    Article  PubMed  Google Scholar 

  60. Oh B, Butow P, Mullan B, Beale P, Pavlakis N, Rosenthal D, et al. The use and perceived benefits resulting from the use of complementary and alternative medicine by cancer patients in Australia. Asia-Pacific J Clin Oncol. 2010;6(4):342–9. Epub 2010/12/01.

    Article  Google Scholar 

  61. Ezeome ER, Anarado AN. Use of complementary and alternative medicine by cancer patients at the University of Nigeria Teaching Hospital, Enugu, Nigeria. BMC Complement Alternat Med. 2007;7:28.

    Article  Google Scholar 

  62. Minja BM. Cancer pain control in Africa (state of the art). J Palliative Care. 1989;5(2):31–4.

    CAS  Google Scholar 

  63. Harding R, Higginson IJ. Palliative care in sub-Saharan Africa. Lancet. 2005;365(9475):1971–7.

    Article  PubMed  Google Scholar 

  64. Koon KP, Lehman CD, Gralow JR. The importance of survivors and partners in improving breast cancer outcomes in Uganda. Breast. 2013;22(2):138–41.

    Article  PubMed  Google Scholar 

  65. Gondos A, Chokunonga E, Brenner H, Parkin DM, Sankila R, Borok MZ, et al. Cancer survival in a southern African urban population. Int J Cancer. 2004;112(5):860–4. Epub 2004/09/24.

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Medicine, School of Medicine, College of Health Sciences, Makerere University, 7072, Kampala, Uganda

    Amos Deogratius Mwaka M.B.Ch.B., M.Med.

  2. Department of Pathology, Kampala Cancer Registry, School of Biomedical Sciences, College of Health Sciences, Makerere University, Kampala, Uganda

    Henry Wabinga M.B.Ch.B., M.Med., M.D.

  3. Department of Community Health and Behavioural Sciences, School of Public Health, College of Health Sciences, Makerere University, 7072, Kampala, Uganda

    Christopher Orach Garimoi M.B.Ch.B., M.P.H., Ph.D.

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  1. Amos Deogratius Mwaka M.B.Ch.B., M.Med.
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  2. Henry Wabinga M.B.Ch.B., M.Med., M.D.
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  3. Christopher Orach Garimoi M.B.Ch.B., M.P.H., Ph.D.
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Correspondence to Amos Deogratius Mwaka M.B.Ch.B., M.Med. .

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Editors and Affiliations

  1. Technion – Israel Institute of Technology, & Middle East Cancer Consortium, Haifa, Haifa, Israel

    Michael Silbermann

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Mwaka, A.D., Wabinga, H., Garimoi, C.O. (2016). Cancer Care in Countries in Transition in Africa: The Case of Uganda. In: Silbermann, M. (eds) Cancer Care in Countries and Societies in Transition. Springer, Cham. https://doi.org/10.1007/978-3-319-22912-6_14

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  • DOI: https://doi.org/10.1007/978-3-319-22912-6_14

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