Uganda Cancer Institute

Cervical cancer is the fourth most common cancer among women with significant global disparities in disease burden. In lower-resource settings, where routine screening for cervical cancer is uncommon, higher incidence of advanced-stage disease contributes to increased morbidity and mortality. Understanding care delays may inform strategies to decrease overall time to treatment, and could potentially improve outcomes. We sought to characterize the cervical cancer care cascade and identify factors associated with time to care cascade completion within a Ugandan cohort. We collected sociodemographic, reproductive health and care journey data from 268 Ugandan women newly diagnosed with cervical cancer at Mulago National Referral Hospital and the Uganda Cancer Institute. We characterized time from symptoms to presentation (patient interval), time from presentation to diagnosis (diagnostic interval) and time from diagnosis to treatment (treatment interval) and estimated the influence of patient, health provider, system, and disease factors on length of each interval using survival analysis. Median patient, diagnostic and treatment intervals were 74 days (IQR 26–238), 83 days (IQR 34–229), and 34 days (IQR 18–58), respectively. Patient interval was prolonged by the belief that symptoms would resolve spontaneously (aHR 0.37, 95

Background:Blood transfusions are essential in the supportive care of patients with hematological malignancies but carry a risk of adverse reactions. Data on the incidence of transfusion reactions remain scarce in Uganda. This study evaluated the incidence of hemolytic and serologic transfusion reactions among patients with hematological malignancies at Mbarara Regional Referral Hospital and the Uganda Cancer Institute in Uganda. Materials and Methods:This prospective cohort study enrolled hospitalized patients aged ≥2 years with hematological malignancies and a history of prior red blood cell (RBC) transfusions. Participants received additional transfusions and were monitored for up to 14 days. Blood samples were collected on day 0 (transfusion day), days 7, and 14 to assess hemoglobin (Hb) levels, lactate dehydrogenase (LDH), and perform direct and indirect antiglobulin tests. Participants' medical records were also reviewed for transfusion and pregnancy histories. Repeated Measures-Analysis of Variance was used to compare mean Hb and LDH levels over time points. Results:Of the 467 participants enrolled (median age: 36.4 years, interquartile range: 27.3-46.9), 382 completed the follow-up period. A progressive increase in mean Hb levels (g/dL) was observed: 6.6 (95% confidence interval [CI]: 6.1-8.9) on day 0, 7.5 (7.3-10.1) on day 7, and 8.9 (8.4-10.6) on day 14. No acute or delayed hemolytic reactions occurred. The incidence of delayed serologic transfusion reactions (DSTRs) was 0.86 in 100 (95% CI: 0.02-1.69), while the overall RBC alloantibody prevalence was 2.4% (95% CI: 0.98-3.74). The identified alloantibodies were directed against antigens in the Rh, Kell, Lewis, and MNS group systems. Conclusion:Despite a low incidence of DSTRs, a notable prevalence of RBC alloimmunization was observed among patients with hematological malignancies. These findings underscore the need to strengthen pre-transfusion antibody testing to prevent hemolytic complications and improve transfusion outcomes in this population.

BACKGROUND:Radiotherapy aims to deliver a uniform dose within ± 5.0% of the prescription, while minimizing toxicity. Because treatment quality directly influences patient's treatment outcomes, error detection is critical for ensuring accuracy and safety. This study evaluated in-vivo dosimetry (IVD) as a quality assurance (QA) tool to detect treatment errors during the transition from two-dimensional radiotherapy (2DRT) with Cobalt-60 units to three-dimensional conformal radiotherapy (3DCRT) with linear accelerators. METHODS:IVD was performed for 612 treatment fields across 493 patients treated with either 2DRT or 3DCRT. A calibrated entrance diode was placed on the patient's skin to measure delivered doses, which were compared with prescribed doses at relevant depths. Deviations exceeding ± 5% were investigated, with findings discussed with oncologists to enable immediate corrective action and subsequently communicated to staff to support continuous learning. RESULTS:Ninety-two errors were identified. The most frequent causes were incorrect calculations (20.7%), procedural changes (15.2%), omission of tray/bolus in treatment time calculations (4.3%), and use of treatment times/monitor units without secondary physics verification (4.3%). Overall, 84.9% of the 612 measurements were within the ± 5% tolerance. CONCLUSIONS:IVD with a calibrated diode provides a simple and effective quality control measure for maintaining treatment accuracy. Systematic error analysis and structured staff feedback enhance awareness, strengthen safety culture, and improve patient care during technological transitions in radiotherapy.

Background: Breast cancer, a disease in which cells in the breast proliferate uncontrollably is the most common type of cancer among women globally. In sub-Saharan Africa, patients with breast cancer present with advanced stage disease for treatment. However, there is no data on the utilization of pharmacy prescription by patients with breast cancer in Uganda. This study explored factors that influence the utilization of available breast cancer pharmacy prescriptions among females at Mbarara regional cancer centre. Methods: A qualitative study was conducted at Mbarara regional cancer centre in western Uganda. In this study, In-depth interviews were conducted with 12 patients and 05 Healthcare workers. Interviews were audio recorded, transcribed verbatim and thematically analyzed using Nvivo-12 plus. Both inductive and deductive approaches to qualitative data coding and analysis were employed. Results Two themes, six sub-themes, and various codes emerged from the data which included: Health facility constraints and patient barriers to care as broad themes and the sub-themes were; drug stockouts, limited human resource and infrastructure, drug side effects, financial and transportation struggles hindering optimal utilization of prescribed therapies. Conclusions This study provides key insights on factors influencing the utilization of pharmacy prescriptions among female breast cancer patients at Mbarara regional cancer centre. Findings reveal a complex interplay of health facility constraints and patient-related challenges that impact access to and utilization to prescribed medications. options further hinder optimal utilization of prescribed therapies. These challenges underscore the need for enhanced patient support systems, including better management of side effects, improved drug availability, and financial assistance programs to mitigate economic burdens. Addressing these barriers requires a multi-faceted approach involving healthcare system improvements, policy interventions, and patient-centered strategies. Strengthening supply chain mechanisms to reduce drug stockouts, increasing healthcare staffing, and enhancing patient education on managing side effects can improve medication utilization and treatment outcomes, particularly within low-resource settings. collaborative effort between healthcare providers, policymakers, and support organizations is essential to ensuring that breast cancer patients receive uninterrupted, high-quality care.

Chemotherapy is a common modality used for management of cancers but some agents are known to cause peripheral neuropathy. Chemotherapy induced peripheral neuropathy (CIPN) refers to a disorder in structure and functionality of peripheral sensory, motor, and autonomic neurons triggered by the toxic effects of these drugs. CIPN is a common adverse drug reaction (ADR) caused by mainly platinum analogs, vinca alkaloids and taxanes. Severe CIPN can cause paresis, complete immobilization and disability. The objectives of this study were to determine the prevalence, factors associated with and evaluate treatment of CIPN among adult patients with cancer at Mbarara Regional Cancer Centre. A cross-sectional study was conducted for a period of 2 months among adult patients with cancer receiving chemotherapy at Mbarara Regional Cancer Centre. Consecutive sampling technique was used to enroll 235 participants into the study. Data collection was done through patient interviews and file reviews. Assessment of the clinical features of CIPN was done using EORTC-QLQ-CIPN20 tool. SPSS version 27 was used for data entry and analysis. The prevalence of CIPN was 31.1