Developing a modern radiotherapy department in a rural hospital in Cameroon: The Mbingo experience.

Although radiotherapy is critical for cancer cure and palliation, access to such expensive and sophisticated technology is very limited in low- and middle-income countries (LMIC). Cancer incidence in Africa is currently 1.5 million case per year, thus urgent and innovative solutions are required to build necessary infrastructure needed to address this global health challenge.

Reflections on 20 years of the Wilms Africa project: Lessons learned and the way forward.

Wilms tumour (WT) is one of the common and curable childhood cancer types included in the Global Initiative for Childhood Cancer (GICC) to monitor progress. Local evidence is key to finding effective and sustainable solutions to local challenges to improve care and survival. Local evidence generated by the Wilms Africa project is summarised with recommendations for the future.

Evaluating implementation of a hospital-based cancer registry to improve childhood cancer care in low- and middle-income countries.

Purpose: Cancer is a leading cause of global childhood mortality, affecting 400,000 children annually. While treatable with modern therapies, children living in low- and middle-income countries (LMICs) have limited access to care and lower survival rates. Hospital-based cancer registries (HBCRs) collect detailed patient information to critically evaluate and evolve care.

Effectiveness of a Wilms tumour treatment guideline adapted to local circumstances in sub-Saharan Africa: A report from Wilms Africa Phase II-CANCaRe Africa.

Background: Wilms tumour (WT) is one of the cancer types targeted by the Global Initiative for Childhood Cancer (GICC). The objective of this study was to describe the outcomes of Wilms Africa Phase II in sub-Saharan Africa.

Methods: Wilms Africa Phase II used a comprehensive WT treatment protocol in a multi-centre, prospective study conducted in eight hospitals in Ethiopia (2), Ghana (2), Malawi, Cameroon, Zimbabwe and Uganda.

Surgical aspects and outcomes after nephrectomy for Wilms tumour in sub-Saharan Africa: A report from Wilms Africa Phase II-CANCaRe Africa.

Background: Wilms tumour (WT) is one of the common and curable cancer types targeted by the Global Initiative for Childhood Cancer. Tumour excision is essential for cure. This analysis focuses on surgical outcomes of patients with WT in sub-Saharan Africa.

Prevention of treatment abandonment remains an important challenge to increase survival of Wilms tumor in sub-Saharan Africa: A report from Wilms Africa-CANCaRe Africa.

Background: The Wilms Africa studies implemented an adapted Wilm's tumor (WT) treatment protocol in sub-Saharan Africa in two phases. Phase I began with four sites and provided out-of-pocket costs. Phase II expanded the number of sites, but lost funding provision.

The diagnosis and management of solid pseudopapillary epithelial neoplasm of the pancreas in a resource-limited setting: two cases from Cameroon.

Solid pseudopapillary epithelial neoplasm (SPEN) of the pancreas is a rare tumor of low malignant potential that occurs most often in young females. Imaging and histopathology are necessary to confirm the diagnosis as most have no symptoms. Lack of access to these technologies in sub-Saharan Africa contributes to the difficulty in making an early and accurate diagnosis, and hence, impedes treatment.

Comparison on treatment outcomes of patients enrolled on anti-retroviral therapy at different levels of the health-care system in a high HIV/AIDS setting.

HIV/AIDS prevalence in Botswana is amongst the highest in the world and remains a significant public health problem. however, the introduction of anti-retroviral therapy (ART) lead to a significant reduction in morbidity and mortality. Decentralization of anti-retroviral therapy has improved access to treatment for people living with HIV.

Using Artificial Intelligence to Gauge Competency on a Novel Laparoscopic Training System.

Objective: Laparoscopic surgical skill assessment and machine learning are often inaccessible to low-and-middle-income countries (LMIC). Our team developed a low-cost laparoscopic training system to teach and assess psychomotor skills required in laparoscopic salpingostomy in LMICs. We performed video review using AI to assess global surgical techniques.

Assessment of barriers to optimal cancer control in adult cancer treatment centres in Cameroon.

Approximately 20,745 new cases of cancer were registered annually with 13,199 (64%) deaths in 2020 in Cameroon. Despite the increasing cancer burden, there is a paucity of reliable data that can enhance decision-making for cancer control in Cameroon. This assessment was, therefore, designed to generate data that may enable stakeholders, policymakers and funders to make data-driven decisions on cancer control.

Assessing knowledge and confidence of surgical residents in inguinal hernia repair using a low-cost synthetic model.

Purpose: Open repair of groin hernia is an essential skill for the general surgeon. This study aimed to develop a low-cost hernia model based on a validated high-fidelity model and assess its effectiveness in teaching inguinal hernia repair to surgical trainees from many institutions throughout Africa.

Methods: Using inexpensive, locally available materials, a low-cost hernia model was created.

Evidence for a case-based module in the low-resource setting to teach ectopic pregnancy management.

Introduction: Case-based learning (CBL) utilizes authentic clinical cases that connect theory to practice. CBL has been shown to result in deeper learning and high engagement of adult learners. An open-source, web-based CBL module was created to help learners develop the cognitive foundation of ectopic pregnancy management in the low-resource setting.

Evidence supporting performance measures of laparoscopic appendectomy through a novel surgical proficiency assessment tool and low-cost laparoscopic training system.

Background: Laparoscopic training remains inaccessible for surgeons in low- and middle-income countries, limiting its widespread adoption. We developed a novel tool for assessment of laparoscopic appendectomy skills through ALL-SAFE, a low-cost laparoscopy training system.

Methods: This pilot study in Ethiopia, Cameroon, and the USA assessed appendectomy skills using the ALL-SAFE training system.

Characterizing factors influencing adherence to surgery and chemotherapy amongst women suffering from breast cancer in Mbingo Baptist Hospital Cameroon.

Introduction: Breast cancer (BC) is the most prominent cancer in females and is cited as a leading cause of cancer-related mortality in women worldwide. We aimed to determine factors influencing adherence to surgery and chemotherapy in women with BC in Mbingo Baptist Hospital (MBH).

Methods: we conducted a cross-sectional study in the MBH-Cameroon.

Validation of Two Asian Noninvasive Risk Models for Predicting Prevalent Undiagnosed Chronic Kidney Disease in Diabetic Patients Receiving Care at a Reference Hospital in A Sub-Saharan African Country: A Cross-Sectional Study.

Undiagnosed chronic kidney disease (CKD) is common in people with diabetes mellitus. Validated noninvasive risk models are an attractive CKD screening option in diabetic patients to identify patients who are more likely to be diagnosed with CKD via biological tests. The study aimed to validate the Korean and Thai noninvasive CKD risk prediction models in African Type 2 diabetic patients.

Assessing knowledge, attitudes and belief toward HPV vaccination of parents with children aged 9-14 years in rural communities of Northwest Cameroon: a qualitative study.

Background: Human papilloma virus (HPV) vaccination is essential for the WHO cervical cancer elimination initiative. In Cameroon, HPV vaccine uptake is currently 5%. To assess the knowledge, beliefs and attitudes of parents of young girls aged 9-14 years about HPV vaccines within rural communities in the Northwest Region of Cameroon.

Risk factors of severe hepatotoxicity among HIV-1 infected individuals initiated on highly active antiretroviral therapy in the Northwest Region of Cameroon.

Background: Hepatotoxicity due to highly active antiretroviral therapy (HAART) has gained prominent attention since it can be affected by many factors. The aim of this study was to determine the prevalence of hepatotoxicity and related risk factors of severe hepatotoxicity following HAART initiation.

Methods: A total of 100 drug-naive patients aged between 18 and 61 years were recruited.

Outcome of retinoblastoma treatment protocol in Cameroon as per SIOP-PODC recommendation for a low-income setting.

Introduction: The International Society of Paediatric Oncology-Paediatric Oncology in Developing Countries (SIOP-PODC) group recommended graduated-intensity retinoblastoma treatment for children in low- and middle-income countries with limited local resources.

Aim: The aim was to improve outcome of children with retinoblastoma by means of a treatment protocol for low-income settings as recommended by the SIOP-PODC recommendation in Cameroon.

Methods: Children diagnosed with retinoblastoma between 2012 and 2016 were treated in two Baptist Mission hospitals in Cameroon, staging according to the International Retinoblastoma Staging System.

Design of a Novel Online, Modular, Flipped-classroom Surgical Curriculum for East, Central, and Southern Africa.

Objective: We describe a structured approach to developing a standardized curriculum for surgical trainees in East, Central, and Southern Africa (ECSA).

Summary Background Data: Surgical education is essential to closing the surgical access gap in ECSA. Given its importance for surgical education, the development of a standardized curriculum was deemed necessary.

Delays to essential surgery at four faith based hospitals in rural Sub-Saharan Africa.

Background: Data regarding delays for emergency surgery in Sub-Saharan Africa is limited. We have therefore decided to undertake an evaluation of delays in patients seeking care, reaching care and receiving care for emergency surgery at four rural faith-based hospitals in this region over a 3 month period.

Methods: This is a cross-sectional, multi-center, international study at four rural faith-based hospitals in Madagascar, Gabon, Cameroon and Burundi.

Predictors of antiretroviral therapy interruptions and factors influencing return to care at the Nkolndongo Health District, Cameroon.

Background: Antiretroviral therapy is a lifelong commitment that requires consistent intake of tablets to optimize health outcomes, attain and maintain viral suppression.

Objective: We aimed to elicit predictors of treatment interruption amongst PLHIV and identify motivating factors influencing return to care.

Method: We conducted a cross-sectional study using a mixed-method approach in four hospitals in Yaoundé.

Infertility and associated factors in three hospitals in Douala, Cameroon: a cross-sectional study.

Aim: We determined the prevalence and factors associated with couple infertility in three hospitals in Douala, Cameroon.

Methods: We conducted a cross-sectional study from December 18th 2015 to March 18th 2016 in three public hospitals in Douala. Three hundred and sixty participants were studied prospectively for associated factors using a multivariate logistic regression model and 4732 files were studied retrospectively for the prevalence of infertility.

Otolaryngology burden of disease and surgical case triage in resource-limited settings: An example from Cameroon.

Objectives: Otolaryngology services worldwide faced an unprecedented demand for case triage during the SARS-CoV-2 pandemic. We propose and apply a novel case-leveling schema in a resource-limited setting. Describing the surgical burden of otolaryngologic disease in this setting may critically inform resource planning to address global surgical disparities.

Cancer and COVID-19 Experiences at African Cancer Centers: The Silver Lining.

Purpose: The COVID-19 pandemic significantly disrupted cancer care in Africa, further exposing major health disparities. This paper compares and contrasts the experiences of 15 clinicians in six different African cancer centers to highlight the positive aspects (silver linings) in an otherwise negative situation.

Methods: Data are from personal experience of the clinicians working at the six cancer centers blended with what is available in the literature.

Burkitt lymphoma: Age Specific Fertility Rate in 113 long-term female survivors after treatment with cyclophosphamide.

Introduction: Reduced fertility risk is a risk in females treated with a high cumulative cyclophosphamide (CPM) dose.

Objectives: The objective of this study is to establish the age at menarche, record all pregnancies, calculate age-specific fertility rate (ASFR) in female BL survivors, treated in Cameroon, in the age groups 15-19 and 20-24 years, and association with an increasing cumulative CPM dose.

Methods: Data collection included personal data and telephone interviews for female survivors, aged ≥12 years with regards to menarche age, their mothers' menarche age, incidence and outcome of all pregnancies.