Anangwe Nelson, Steimgrimson Jon, Cu-Uvin Susan
Moi University.
Brown University.
Res Sq. 2024 Aug 28:rs.3.rs-4791370. doi: 10.21203/rs.3.rs-4791370/v1.
Cervical cancer cases are increasing in sub-Saharan Africa, particularly in Kenya, exacerbated by inadequate histopathology resources, posing a significant barrier to timely diagnosis and treatment. There has been little research on the availability and evolution of histopathology resources for diagnosing cervical cancer over the years. This retrospective study evaluated this evolution at Moi Teaching and Referral Hospital in Kenya between 2018 and 2022.
We used a mixed-methods approach. An in-depth interview was conducted with one of MTRH's pathology laboratory staff to assess the equipment, personnel, and quality control trends between 2018 and 2022. A thematic analysis was conducted in NVivo. We also retrospectively conducted a comprehensive inventory review of laboratory resources from 2018-2022 via purposive sampling. Microsoft Excel and Stata version 17 were utilized for descriptive statistical analysis. Turnaround time (TAT) was assessed against the UK's National Health Service Cervical Screening Program guidelines.
The number of histopathology laboratory personnel at MTRH increased from 2018 to 2022, during which the facility included two pathologists, one records person, and one office administrator. Patient annual visits increased from approximately 350,000 in 2018 to approximately 500,000 in 2022. However, the histopathology personnel-to-population ratio decreased from 1.5 pathologists and 2.7 histo-technicians per 100,000 in 2018 to 1.4 pathologists and 1.8 histo-technicians per 100,000 in 2022. Despite this decrease, lab equipment, automatic tissue processors and embedding machines were added, and an average 14-day turnaround time was maintained for pathology reports.
Despite a decreased personnel-to-patient ratio, the addition of crucial histopathology equipment mirrors the operational commitment of the Moi Teaching and Referral Hospital. The 14-day TAT is commendable, contributes to operational effectiveness and significantly contributes to timely detection. The hospital's dedication to upgrading its infrastructure underscores a proactive approach to addressing growing healthcare demands and improving patient outcomes, even with limited human resources. The decline in the personnel-to-patient ratio underscores challenges in diagnosis, emphasizing the need to address workforce and infrastructure gaps to improve patient care within similar low-resource settings.
撒哈拉以南非洲地区，尤其是肯尼亚的宫颈癌病例不断增加，组织病理学资源不足加剧了这一情况，对及时诊断和治疗构成了重大障碍。多年来，关于用于诊断宫颈癌的组织病理学资源的可获得性和演变情况的研究很少。这项回顾性研究评估了2018年至2022年期间肯尼亚莫伊教学与转诊医院的这一演变情况。
我们采用了混合方法。对莫伊教学与转诊医院病理实验室的一名工作人员进行了深入访谈，以评估2018年至2022年期间的设备、人员和质量控制趋势。在NVivo中进行了主题分析。我们还通过目的抽样对2018 - 2022年的实验室资源进行了回顾性全面清查。使用Microsoft Excel和Stata 17版本进行描述性统计分析。根据英国国家医疗服务体系宫颈癌筛查计划指南评估周转时间（TAT）。
2018年至2022年期间，莫伊教学与转诊医院组织病理学实验室的人员数量有所增加，在此期间该机构有两名病理学家、一名记录员和一名办公室管理人员。患者年度就诊人数从2018年的约35万增加到2022年的约50万。然而，组织病理学人员与人口的比例从2018年每10万人中有1.5名病理学家和2.7名组织技术人员下降到2022年每10万人中有1.4名病理学家和1.8名组织技术人员。尽管有所下降，但仍增加了实验室设备、自动组织处理机和包埋机，病理报告的平均周转时间保持在14天。
尽管人员与患者的比例有所下降，但关键组织病理学设备的增加反映了莫伊教学与转诊医院的运营投入。14天的周转时间值得称赞，有助于提高运营效率，并对及时检测做出了重大贡献。即使人力资源有限，该医院致力于升级其基础设施，凸显了一种积极主动的方式来应对不断增长的医疗需求并改善患者治疗效果。人员与患者比例的下降凸显了诊断方面的挑战，强调需要解决劳动力和基础设施方面的差距，以改善类似资源匮乏环境下的患者护理。
