Background: We evaluated whether structured teleoncology could support the safe and affordable delivery of systemic oncology treatment at a provincial Angolan hospital without such installed capacity previously.Methods: Retrospective cohort study at Lubango Central Hospital (HCL), Angola, as a proof of principle, September 2024-May 2025. The initial analysis covered 85 patients discussed at a multidisciplinary tumor board (MTB) by videoconference; a second analysis assessed safety, outcomes, and costs in 23 patients treated at HCL. Efficacy was judged against palliative-intent indicators.Results: In a cohort presenting overwhelmingly with advanced disease (87.0% stage III-IV), 93 cycles were delivered under remote supervision with no preparation errors, no contamination, no grade 4-5 adverse events (95% confidence interval 0-4.0%), no toxicity admissions, and no treatment-related deaths. Course completion reached 89.5%. The MTB processed 156 consultations and met all technical and operational targets; grade 1-3 events occurred in 16.1% of cycles, and partial remission reached 52.6%. Symptom onset to first presentation had a median of 6 months (range 1-11.7); the program-attributable interval was 1-2 weeks. Unit cost was 223,000 US dollars (USD); the drug cost was 251.93 USD per patient, against 643-794 USD averted per course in travel, lodging, and subsistence, and 533 USD per cycle in personnel costs (base salary).Conclusions: This program showed that systemic treatment under remote supervision was delivered safely and feasibly without a resident medical oncologist, with household savings of two and a half to three times the drug cost. This proof of principle suggests that the model may be workable elsewhere, though the small sample and absence of a control group limit firmer conclusions.
IntroduçãoActualmente regista-se uma mudança do perfil epidemiológico da população angolana com aumento das doenças cardiovasculares (com particular destaque para o Acidente Vascular Cerebral) e oncológicas, mantendo-se igualmente as doenças inflamatórias/infeciosas, o que condiciona crescente complexidade dos cuidados de saúde e de gestão das despesas com cuidados de saúde, aliadas a necessidade de cumprir-se com as orientações da boa prática de medicina centrada no paciente. Introduction At present, a shift in the epidemiological profile of the Angolan population is being observed, with an increase in cardiovascular diseases (particularly stroke) and oncological conditions, while inflammatory and infectious diseases remain prevalent. This scenario leads to growing complexity in healthcare delivery and in the management of healthcare expenditure, alongside the need to comply with the principles of good practice in patient-centred medicine.
Introdudção: A Tomografia Computorizada (TC) é uma técnica de diagnóstico por imagem em constante evolução, aumentando a necessidade de medidas de Proteção e Segurança Radiológica (PSR). Os Níveis de Referência de Diagnóstico (NRDs) auxiliam na otimização da dose de radiação. Há disparidades no uso da TC entre a Europa e África, sendo que Angola tem avançado na aquisição de tecnologia e sensibilização para a PSR, mas ainda não possui NRDs estabelecidos. Este estudo compara os NRDs praticados em Angola com os europeus para exames de TC Crânio-Encefálica (CE), Tórax e Coluna Lombar. Materiais e Métodos: Foram analisados exames realizados na CSE, em Angola, utilizando o TC FujiFilm Scenaria View 64 cortes. Os parâmetros CTDIvol (Índice de Dose em Tomografia Computorizada) e DLP (Produto Dose Comprimento) foram selecionados em pacientes adultos (≥18 anos). Resultados: O Indice de Massa Corporal (IMC) variou entre Tórax (22,5) e Coluna Lombar (25,3). Os valores médios de CTDIvol foram: CE (55,4), Coluna Lombar (21,0) e Tórax (2,2). O DLP foi maior na CE (950,3), seguido da Coluna Lombar (542,0) e Tórax (78,7). O aumento do IMC esteve associado ao aumento das doses de radiação. Conclusão: As diferenças entre os valores praticados na Clínica Sagrada Esperança e os NRDs internacionais podem estar relacionadas a fatores que influenciam a dose necessária para imagens diagnósticas. Os valores praticados na CSE estão alinhados com níveis de referência na CSE, reforçando a importância da implementação dos NRDs para a proteção radiológica em Angola.AbstractBackground: Computed Tomography (CT) is a constantly evolving imaging diagnostic technique, increasing the need for RadiationProtection and Safety (RPS) measures. Diagnostic Reference Levels (DRLs) assist in optimizing radiation doses. There are disparitiesin the use of CT between Europe and Africa, with Angola making progress in acquiring technology and raising awareness of RPS, butit still lacks established DRLs. This study compares the DRLs practiced in Angola with European standards for Cranial-Cerebral (CC),Thorax, and Lumbar Spine CT scans.Materials and Methods: Exams performed at CSE in Angola were analyzed using the FujiFilm Scenaria View 64-slice CT scanner. TheCTDIvol (Computed Tomography Dose Index) and DLP (Dose-Length Product) parameters were selected for adult patients (≥18 years).Results: Body Mass Index (BMI) ranged between Thorax (22.5) and Lumbar Spine (25.3). The mean CTDIvol values were: CC (55.4),Lumbar Spine (21.0), and Thorax (2.2). The highest DLP was in CC (950.3), followed by the Lumbar Spine (542.0) and Thorax (78.7). Anincrease in BMI was associated with higher radiation doses.Conclusion: The differences between the values practiced at Clínica Sagrada Esperança and international DRLs may be related tofactors influencing the necessary dose for diagnostic imaging. The values practiced at CSE align with reference levels at CSE, reinforcingthe importance of implementing DRLs for radiation protection in Angola.
RESUMO INRODUÇÃO: Este estudo avaliou os factores associados à infeção pós-exposição à COVID-19 em profissionais de saúde da Clínica Sagrada Esperança (CSE), em Luanda, entre março de 2020 e março de 2021. A COVID-19, causada pelo vírus SARS-CoV-2, é altamente contagiosa, representando um desafio significativo para os profissionais de saúde devido à exposição direta a pacientes infetados e aos riscos das práticas hospitalares. O estudo teve como objectivo identificar factores de risco relacionados à infecção, avaliando a adesão às medidas de prevenção e controlo de infeções (PCI) e o uso de equipamentos de protecção individual (EPIs), além de propor estratégias de mitigação. MÉTODOS: Foi realizado um estudo observacional, transversal e analítico, com 149 profissionais da CSE que prestaram assistência a pacientes com COVID-19. A recolha de dados incluiu entrevistas presenciais e telefónicas, com análise multivariada para avaliar associações entre variáveis como idade, sexo, adesão às medidas de PCI, uso de EPIs e infecção pós-exposição: RESULTADOS: A média de idade dos participantes foi de 32,1 anos, sendo 53,69% do sexo masculino e 49,67% com ensino secundário. Embora todos relataram o uso de EPIs, 26,8% apresentaram falhas na sua remoção e troca. Procedimentos geradores de aerossóis aumentaram significativamente o risco de infeção (OR ajustado: 20,98; IC 95%: 10,499-41,910), assim como o uso inadequado de máscaras N95/PFF2 e batas impermeáveis (OR ajustado 48,26; IC95%: 20,064 - 116,089). CONCLUSÃO: Apesar do uso generalizado de EPIs, práticas inadequadas e exposição a procedimentos de alto risco aumentaram o risco de infeção. É essencial reforçar medidas educativas, monitoria e avaliação e políticas de segurança ocupacional para proteger os profissionais de saúde durante pandemias. Palavras-chaves: Avaliação, Infecção pós-exposição, COVID-19, Profissionais de saúde ABSTRACT Introduction: This study evaluated the factors associated with post-exposure COVID-19 infection among healthcare professionals at Clinica Sagrada Esperança (CSE) in Luanda, between March 2020 and March 2021. COVID-19, caused by the SARS-CoV-2 virus, is highly contagious, posing significant challenges to healthcare professionals due to direct exposure to infected patients and the risks associated with hospital practices. The study aimed to identify risk factors related to infection by assessing adherence to infection prevention and control (IPC) measures and the use of personal protective equipment (PPE), while proposing mitigation strategies. Methods: A cross-sectional, analytical observational study was conducted with 149 healthcare professionals at CSE who provided care to COVID-19 patients. Data collection involved face-to-face and telephone interviews, and multivariate analysis was used to assess associations between variables such as age, gender, adherence to IPC measures, PPE use, and post-exposure infection. Results: The participants' mean age was 32.1 years; 53.69% were male, and 49.67% had completed secondary education. Although all participants reported PPE usage, 26.8% demonstrated failures in removing or replacing PPE according to protocols. Aerosol-generating procedures significantly increased infection risk (adjusted OR: 20.98; 95% CI: 10.499-41.910), as did inadequate use of N95/PFF2 masks and impermeable gowns. Conclusion: Despite widespread PPE use, inadequate practices and exposure to high-risk procedures increased infection risk. It is essential to reinforce educational measures, continuous monitoring, and occupational safety policies to protect healthcare professionals during pandemics. Keywords: Assessment, Post-exposure infection, COVID-19, CSE staff.
Chronic pediatric diseases are a growing challenge because of their impact on morbidity and healthcare resource utilization. In Angola, evidence on the hospital burden of chronic diseases, particularly sickle cell anemia (SCA), remains limited. This study compared the clinical characteristics, management, and outcomes of children hospitalized with SCA and those with other chronic diseases. We conducted a retrospective observational study of children aged 1 month to 15 years admitted to the Department of Pediatrics of Clínica Sagrada Esperança, Luanda, Angola, between January and December 2024. Clinical, laboratory, treatment, and outcome data were extracted from electronic medical records. Continuous variables were compared using the Mann–Whitney U test and categorical variables using Pearson’s chi-square or Fisher’s exact tests. Median regression adjusted for age and sex assessed differences in admission hemoglobin levels. Among 1,169 pediatric admissions, 262 involving chronic diseases met the eligibility criteria, including 97 (37.0
