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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
Developing clinical strength-of-evidence approach to define HIV-associated malignancies for cancer registration in Kenya
PLoS ONE, Volume 9, No. 1, Article e85881, Year 2014
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Description
Background: Sub-Saharan Africa cancer registries are beset by an increasing cancer burden further exacerbated by the AIDS epidemic where there are limited capabilities for cancer-AIDS match co-registration. We undertook a pilot study based on a "strength-of-evidence" approach using clinical data that is abstracted at the time of cancer registration for purposes of linking cancer diagnosis to AIDS diagnosis. Methods/Findings: The standard Nairobi Cancer Registry form was modified for registrars to abstract the following clinical data from medical records regarding HIV infection/AIDS in a hierarchal approach at time of cancer registration from highest-to-lowest strength-of-evidence: 1) documentation of positive HIV serology; 2) antiretroviral drug prescription; 3) CD4+ lymphocyte count; and 4) WHO HIV clinical stage or immune suppression syndrome (ISS), which is Kenyan terminology for AIDS. Between August 1 and October 31, 2011 a total of 1,200 cancer cases were registered. Of these, 171 cases (14.3%) met clinical strength-of-evidence criteria for association with HIV infection/AIDS; 69% (118 cases were tumor types with known HIV association - Kaposi's sarcoma, cervical cancer, non-Hodgkin's and Hodgkin's lymphoma, and conjunctiva carcinoma) and 31% (53) were consistent with non-AIDS defining cancers. Verifiable positive HIV serology was identified in 47 (27%) cases for an absolute seroprevalence rate of 4% among the cancer registered cases with an upper boundary of 14% among those meeting at least one of strength-of-evidence criteria. Conclusions/Significance: This pilot demonstration of a hierarchal, clinical strength-of-evidence approach for cancer-AIDS registration in Kenya establishes feasibility, is readily adaptable, pragmatic, and does not require additional resources for critically under staffed cancer registries. Cancer is an emerging public health challenge, and African nations need to develop well designed population-based studies in order to better define the impact and spectrum of malignant disease in the backdrop of HIV infection. © 2014 Korir et al.
Authors & Co-Authors
Korir, Anne R.
Kenya, Nairobi
Kenya Medical Research Institute
Mauti, Nathan
Kenya, Nairobi
Kenya Medical Research Institute
Moats, Pamela
United States, Morgantown
West Virginia University Hospitals Incorporated
Gurka, Matthew J.
United States, Morgantown
West Virginia University
Mutuma, G. Z.
Kenya, Nairobi
Kenya Medical Research Institute
Metheny, Christine
United States, Morgantown
West Virginia University Hospitals Incorporated
Mwamba, Peter M.
Kenya, Nairobi
University of Nairobi College of Health Sciences
Oyiro, Peter
Kenya, Nairobi
University of Nairobi College of Health Sciences
Fisher, Melanie
United States, Morgantown
West Virginia University School of Medicine Morgantown
Ayers, Leona W.
United States, Columbus
The Ohio State University College of Medicine
Rochford, Rosemary A.
United States, Syracuse
Suny Upstate Medical University
Mwanda, Walter O.
Kenya, Nairobi
University of Nairobi College of Health Sciences
Remick, Scot C.
United States, Morgantown
West Virginia University School of Medicine Morgantown
Statistics
Citations: 13
Authors: 13
Affiliations: 7
Identifiers
Doi:
10.1371/journal.pone.0085881
e-ISSN:
19326203
Research Areas
Cancer
Infectious Diseases
Study Design
Cross Sectional Study
Study Locations
Kenya