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Article ; Online: Building Modern Cancer Care Services in Sub-Saharan Africa Based on a Clinical-Research Care Model.

Orem, Jackson

American Society of Clinical Oncology educational book. American Society of Clinical Oncology. Annual Meeting

2022 Volume 42, Page(s) 1–6

Abstract: Cancer is as old as humankind; there are examples of cancer treatment in ancient Egyptian civilizations. Globally, there has been rapid evolution of oncologic practices over many decades using different modalities, their complexities notwithstanding. ... ...

Abstract	Cancer is as old as humankind; there are examples of cancer treatment in ancient Egyptian civilizations. Globally, there has been rapid evolution of oncologic practices over many decades using different modalities, their complexities notwithstanding. These developments have resulted in visible improvements in outcomes for a complex medical condition.
MeSH term(s)	Africa South of the Sahara/epidemiology ; Humans ; Neoplasms/epidemiology ; Neoplasms/therapy
Language	English
Publishing date	2022-05-17
Publishing country	United States
Document type	Journal Article
ZDB-ID	2431126-1
ISSN	1548-8756 ; 1548-8748
ISSN (online)	1548-8756
ISSN	1548-8748
DOI	10.1200/EDBK_349953
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Article: Cancer prevention and control: Kaposi's sarcoma.

Orem, Jackson

Ecancermedicalscience

2019 Volume 13, Page(s) 951

Abstract: Kaposi's sarcoma (KS) is a vascular tumour of endothelial origin that is associated with human herpes virus-8 infection. In sub-Saharan Africa, AIDS-KS remains the most common HIV-associated malignancy, and hence it poses a huge burden to the already ... ...

Abstract	Kaposi's sarcoma (KS) is a vascular tumour of endothelial origin that is associated with human herpes virus-8 infection. In sub-Saharan Africa, AIDS-KS remains the most common HIV-associated malignancy, and hence it poses a huge burden to the already constrained health-care systems. KS has four clinical variants, namely, classic, endemic, iatrogenic and epidemic KS. The histopathology in these different KS forms is essentially identical; however, they have different clinical patterns. Expanding knowledge of KS biology increases hope for prevention, disease control, and hence better quality of life among patients. Primary prevention strategy for KS-associated herpes virus and management of disease complication, such as lymphoedema should be the focus of disease-prevention and -control research.
Language	English
Publishing date	2019-07-25
Publishing country	England
Document type	Journal Article
ISSN	1754-6605
ISSN	1754-6605
DOI	10.3332/ecancer.2019.951
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Article ; Online: A Quasi-experimental Study Evaluating the Effectiveness of Cryotherapy on Chemotherapy-induced Oral Mucositis Prevention at the Uganda Cancer Institute.

Kamulegeya, Adriane / Rwenyonyi, Charles Mugisha / Orem, Jackson / Nakanjako, Damalie

Journal of health care for the poor and underserved

2024 Volume 34, Issue 4, Page(s) 1386–1397

Abstract: Introduction: Low-cost interventions such as cryotherapy are not routinely practiced in sub-Saharan Africa to prevent chemotherapeutic-induced oral mucositis. We investigated the feasibility and effect of cryotherapy on oral mucositis at the Uganda ... ...

Abstract	Introduction: Low-cost interventions such as cryotherapy are not routinely practiced in sub-Saharan Africa to prevent chemotherapeutic-induced oral mucositis. We investigated the feasibility and effect of cryotherapy on oral mucositis at the Uganda Cancer Institute. Methods: This was a quasi-experimental nonequivalent research study design. We had two groups with each group meant to have 100 participants. We analyzed based on participants who underwent the protocol procedures. Results: Only cancer types were significantly different between the control and intervention groups (χ2=31.09, df =18, p=.030). Twenty percent (n=19) out of the 95, while 8.2% (n=7) out of the 85 in the control and intervention groups respectively developed moderate to severe mucositis (Mantel-Cox and Generalized Wilcoxon p= .026 and p=.031, respectively). Conclusion: The use of cryotherapy in our local setting and many sub-Saharan African countries is feasible and affordable to prevent and control chemotherapy-induced oral mucositis.
MeSH term(s)	Humans ; Stomatitis/chemically induced ; Stomatitis/prevention & control ; Cryotherapy/methods ; Uganda ; Female ; Male ; Antineoplastic Agents/adverse effects ; Adult ; Middle Aged ; Neoplasms/drug therapy ; Young Adult ; Feasibility Studies ; Aged ; Adolescent
Chemical Substances	Antineoplastic Agents
Language	English
Publishing date	2024-04-25
Publishing country	United States
Document type	Journal Article
ZDB-ID	1142637-8
ISSN	1548-6869 ; 1049-2089
ISSN (online)	1548-6869
ISSN	1049-2089
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Article: Patient-reported oral mucositis in solid tumour patients undergoing chemotherapy: a Ugandan experience.

Kamulegeya, Adriane / Rwenyonyi, Charles Mugisha / Orem, Jackson

Ecancermedicalscience

2023 Volume 17, Page(s) 1536

Abstract: Purpose: The mitotic rate of the gastrointestinal tract (GIT) mucosa predisposes the entire system to chemotherapeutic-induced mucositis but the oral cavity due to its accessibility provides an opening to evaluate the extent of the problem much more ... ...

Abstract	Purpose: The mitotic rate of the gastrointestinal tract (GIT) mucosa predisposes the entire system to chemotherapeutic-induced mucositis but the oral cavity due to its accessibility provides an opening to evaluate the extent of the problem much more easily. In addition, the oral cavity being the gateway to the GIT affects the feeding ability of the patient when the ulcers set in.It is therefore from this perspective that we embarked on a study to evaluate the extent of mucositis among patients being treated for solid tumours at our centre. Methods: Using the mouth and throat soreness (OMDQ MTS) questionnaire, we prospectively evaluated mucositis among 100 patients undergoing chemotherapy for solid tumours at the Uganda Cancer Institute. In addition to patient reported outcomes, we also had clinician assessed mucositis measurements. Results: Approximately, 50% of the participants were breast cancer patients. The results demonstrated that patient assessment of mucositis is possible in our setting at a 76% full compliance rate. Up to 30% of our patients reported moderate-to-severe mucositis, though the figure was lower as assessed by the clinicians. Conclusions: The self-reported OMDQ MTS can be useful in our setting for daily mucositis evaluation, hence leading to timely hospital visits before the manifestation of severe complications.
Language	English
Publishing date	2023-04-21
Publishing country	England
Document type	Journal Article
ISSN	1754-6605
ISSN	1754-6605
DOI	10.3332/ecancer.2023.1536
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Article ; Online: Errors in manual radiotherapy treatment procedures and their evolution in a low resource setting: Uganda's experience.

Komakech, Ignatius / Okello, Denis / Kavuma, Awusi / Orem, Jackson / Tagoe, Samuel Nii Adu / Wygoda, Annette

Physica medica : PM : an international journal devoted to the applications of physics to medicine and biology : official journal of the Italian Association of Biomedical Physics (AIFB)

2024 Volume 118, Page(s) 103212

Abstract: Purpose: In Uganda, two-dimensional (2D) radiotherapy treatments have been in use since the establishment of radiotherapy in 1995. Preliminary investigations of treatment records in November 2019 showed evidence of gaps requiring urgent attention. The ... ...

Abstract	Purpose: In Uganda, two-dimensional (2D) radiotherapy treatments have been in use since the establishment of radiotherapy in 1995. Preliminary investigations of treatment records in November 2019 showed evidence of gaps requiring urgent attention. The purpose of this study was to improve the safety of the treatments. Methods: Records of 1164 patients treated in 1387 courses (1412 sites) on Cobalt-60 units were reviewed todetermine the frequency and dosimetric implications of events that occurred at different stepsof the radiotherapy process. The results were presented and discussed with the differentprofessionals for learning purposes. Results: Most common dosimetric eventswere omission of block tray, bolus and couch transmission factors in time calculations, incorrect field sizes and depths, wrong beam weighting, independent calculations and prescription doses contributing 28.6 %, 10.1 %, 6.0 %,11.9 %, 10.1 %, 5.4 %, 4.8 % and 8.9 % to the 168 observed errors. Comparison of the calculated treatment doses with the prescribed doses showed that 88 % of the 1412 sites were treated with radiation doses within an accuracy of ± 5 %. However, an analysis of the evolution along the years demonstrated an improvement from 82.8 % in 2018 to 86.1 % in 2019, and 93.2 % in 2020. Most common procedural events were incomplete setup instructions and missing patient data in the record and verify system of the Co-60 units for 57 % and 60.1 % of the 1164 patients. Conclusions: Opportunities for improvement of safety in the delivery of radiotherapy treatments were identified. Learning from these past errors should raise awareness in the team leading to a safer treatments.
MeSH term(s)	Humans ; Radiotherapy Planning, Computer-Assisted/methods ; Radiotherapy Dosage ; Uganda ; Radiometry ; Radiation Oncology
Language	English
Publishing date	2024-01-13
Publishing country	Italy
Document type	Journal Article
ZDB-ID	1122650-x
ISSN	1724-191X ; 1120-1797
ISSN (online)	1724-191X
ISSN	1120-1797
DOI	10.1016/j.ejmp.2024.103212
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Je nach Verfügbarkeit (siehe Angabe bei Bestand)
bis Jg. 2021: Bestellungen von Artikeln über das Online-Bestellformular
ab Jg. 2022: Lesesaal (EG)

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Article ; Online: Health-related quality of life among adult patients with cancer in Uganda - a cross-sectional study.

Naamala, Allen / Eriksson, Lars E / Orem, Jackson / Nalwadda, Gorrette K / Kabir, Zarina Nahar / Wettergren, Lena

Global health action

2024 Volume 17, Issue 1, Page(s) 2325728

Abstract: Objectives: The study aimed to investigate the prevalence and factors associated with poor health-related quality of life in adults with cancer in Uganda.: Methods: This cross-sectional study surveyed 385 adult patients (95% response rate) with ... ...

Abstract	Objectives: The study aimed to investigate the prevalence and factors associated with poor health-related quality of life in adults with cancer in Uganda. Methods: This cross-sectional study surveyed 385 adult patients (95% response rate) with various cancers at a specialised oncology facility in Uganda. Health-related quality of life was measured using the EORTC QLQ-C30 in the Luganda and English languages. Predetermined validated clinical thresholds were applied to the instrument in order to identify patients with poor health-related quality of life, that is, functional impairments or symptoms warranting concern. Multivariable logistic regression was used to identify factors associated with poor health-related quality of life in six subscales: Physical Function, Role Function, Emotional Function, Social Function, Pain and Fatigue. Results: The mean age of the patients was 48 years. The majority self-reported poor functioning ranging between 61% (Emotional Function) to 79% (Physical Function) and symptoms (Fatigue 63%, Pain 80%) at clinically concerning levels. These patients were more likely to be older, without formal education and not currently working. Being an inpatient at the facility and being diagnosed with cervical cancer or leukaemia was a predictor of poor health-related quality of life. Conclusion: Improvement of cancer care in East Africa requires a comprehensive and integrated approach that addresses various challenges specific to the region. Such strategies include investment in healthcare infrastructure, for example, clinical guidelines to improve pain management, and patient education and support services.
MeSH term(s)	Adult ; Female ; Humans ; Middle Aged ; Quality of Life/psychology ; Cross-Sectional Studies ; Uganda/epidemiology ; Pain/epidemiology ; Pain/psychology ; Surveys and Questionnaires ; Uterine Cervical Neoplasms ; Fatigue/epidemiology ; Fatigue/etiology ; Fatigue/psychology
Language	English
Publishing date	2024-04-10
Publishing country	United States
Document type	Journal Article
ZDB-ID	2540569-X
ISSN	1654-9880 ; 1654-9880
ISSN (online)	1654-9880
ISSN	1654-9880
DOI	10.1080/16549716.2024.2325728
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Article ; Online: Acceptability of Integrated Community-Based HIV and Cervical Cancer Screening in Mayuge District, Uganda.

Mezei, Alex / Trawin, Jessica / Payne, Beth / Rawat, Angeli / Naguti, Priscilla / Orem, Jackson / Murray, Melanie C M / Nakisige, Carolyn / Ogilvie, Gina

JCO global oncology

2024 Volume 10, Page(s) e2200324

Abstract: Purpose: To assess the acceptability of integrated screening for cervical cancer and HIV in the community setting.: Methods: We developed surveys for patients and community health workers (CHWs) who participated in the Advances in Screening and ... ...

Abstract	Purpose: To assess the acceptability of integrated screening for cervical cancer and HIV in the community setting. Methods: We developed surveys for patients and community health workers (CHWs) who participated in the Advances in Screening and Prevention in Reproductive Cancers (ASPIRE) Mayuge trial that compared self-collected human papillomavirus testing at home versus community health meetings in Mayuge district, Uganda. Quantitative data were summarized using descriptive statistics. Open-ended questions were analyzed using an inductive approach with thematic content analysis. Results: We conducted 102 patient surveys and 31 CHW surveys between June and August 2021. Ninety-nine percent of patients and 100% of CHWs indicated that they would find the addition of an HIV test to their self-collected cervical cancer test acceptable. The most frequently stated reasons in favor of adding an HIV test to the ASPIRE Mayuge cervical cancer screening pathways were time-saving, privacy, and support from other women and CHWs. The most frequently stated reasons against integrated screening were related to concerns about confidentiality, most often in reference to women's family members and other women in their village. Conclusion: Integrated community-based cervical cancer and HIV testing would be highly acceptable to both women and CHWs.
MeSH term(s)	Humans ; Female ; Early Detection of Cancer ; Uterine Cervical Neoplasms/diagnosis ; Uterine Cervical Neoplasms/prevention & control ; Uganda/epidemiology ; Mass Screening ; HIV Infections/diagnosis ; HIV Infections/epidemiology ; HIV Infections/prevention & control
Language	English
Publishing date	2024-01-18
Publishing country	United States
Document type	Journal Article
ISSN	2687-8941
ISSN (online)	2687-8941
DOI	10.1200/GO.22.00324
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Article: CTX-M, TEM, and SHV Genes in

Lubwama, Margaret / Kateete, David P / Katende, George / Kigozi, Edgar / Orem, Jackson / Phipps, Warren / Bwanga, Freddie

Infection and drug resistance

2024 Volume 17, Page(s) 641–653

Abstract: Purpose: We determined the phenotypic resistance to third-generation cephalosporins, phenotypic extended spectrum beta-lactamase (ESBL) prevalence, and genotypic prevalence of ESBL-encoding genes : Patients and methods: Blood cultures from ... ...

Abstract	Purpose: We determined the phenotypic resistance to third-generation cephalosporins, phenotypic extended spectrum beta-lactamase (ESBL) prevalence, and genotypic prevalence of ESBL-encoding genes Patients and methods: Blood cultures from hematologic cancer patients with febrile neutropenia were processed in BACTEC 9120. Results: Two hundred and two patients were included in the study. Median age of patients was 19 years (IQR: 10-30 years). Majority (N=119, 59%) were male patients. Sixty (30%) of the participants had at least one febrile episode due to Enterobacteriaceae. Eighty-three organisms were isolated with Conclusion: ESBL-producing Enterobacteriaceae are a predominant cause of bacteremia in hematologic cancer patients at UCI. The most common ESBL-encoding gene identified in the ESBL-PE was
Language	English
Publishing date	2024-02-16
Publishing country	New Zealand
Document type	Journal Article
ZDB-ID	2494856-1
ISSN	1178-6973
ISSN	1178-6973
DOI	10.2147/IDR.S442646
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Article: Barriers to and facilitators of prostate cancer screening among men in Uganda prisons.

Atuhe, Innocent / Jatho, Alfred / Nalwadda, Babra / Basaza-Ejiri, Annabella Habinka / Atuyambe, Lynn / Orem, Jackson

Ecancermedicalscience

2023 Volume 17, Page(s) 1563

Abstract: Background: Studies have shown that prostate cancer (PCa) is increasing at a rate of 5.2% per annum in Uganda and as few as 5% of men have ever been screened for PCa in Uganda. The situation may be worse among male prisoners given their 'vulnerable ... ...

Abstract	Background: Studies have shown that prostate cancer (PCa) is increasing at a rate of 5.2% per annum in Uganda and as few as 5% of men have ever been screened for PCa in Uganda. The situation may be worse among male prisoners given their 'vulnerable status'. The goal of this study was to examine the perceptions, attitudes and beliefs of men in Ugandan prisons regarding barriers to and facilitators of PCa screening. This would enable the identification of potential interventional strategies to promote PCa screening among men in Ugandan prisons. Methods: This study applied the explanatory sequential mixed methods study design. We first conducted 20 focus group discussions and 17 key informant interviews. The qualitative data were analysed to enrich a survey among 2,565 prisoners selected using a simple random sampling technique. Results: Qualitatively, the belief that all cancers have no cure was a barrier against most participants considering screening to be of any value, coupled with the fear of screening positive for PCa and the associated stress. In addition, poor PCa knowledge and lack of PCa screening services in prisons were perceived as barriers to PCa screening in prison settings.The quantitative data from the survey of 2,565 participants with a mean age of 50.2 (9.8), indicated that the main barriers to PCa screening were mainly myths, beliefs, lack of screening facilities and technical capacity. The majority believed that creating PCa awareness, conducting screening outreach in prisons, and providing equipment for PCa screening in prisons health facilities will facilitate PCa screening, as well as working with the Uganda prison service to train the prison health staff to perform PCa screen to facilitate Prison Health Centres capacity to screen for PCa. Conclusion: There is a need to develop interventions to increase awareness among the inmates in the prison health system, while ensuring that the prison health facilities are equipped with the required screening logistics, backed with outreaches from cancer-specialised hospitals/facilities.
Language	English
Publishing date	2023-06-22
Publishing country	England
Document type	Journal Article
ISSN	1754-6605
ISSN	1754-6605
DOI	10.3332/ecancer.2023.1563
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Article: Clinicopathological characteristics and treatment outcomes of oesophageal cancer patients in Uganda.

Obayo, Siraji / Mulumba, Yusuf / Thompson, Cheryl L / Gibson, Michael K / Cooney, Matthew M / Orem, Jackson

Ecancermedicalscience

2023 Volume 17, Page(s) 1576

Abstract: Background: Oesophageal cancer is the seventh most common cancer and the sixth leading cause of cancer death worldwide, and its incidence varies globally. In Uganda, the incidence and trend are on the increase. However, there is a paucity of published ... ...

Abstract	Background: Oesophageal cancer is the seventh most common cancer and the sixth leading cause of cancer death worldwide, and its incidence varies globally. In Uganda, the incidence and trend are on the increase. However, there is a paucity of published data regarding this population's oesophageal cancer clinicopathologic characterisation and treatment outcomes. Objectives: To study the patients' clinicopathologic characteristics and treatment outcomes of oesophageal cancer over 10 years at the Uganda Cancer Institute. Methods: Patients' charts with histologically confirmed diagnoses of oesophageal cancer for 2009-2019 were identified. Case information, which included patient demographics, history of alcohol use or smoking, tumour location, histological type, tumour grade, clinical TNM (Tumour, Node, Metastasis) staging treatment exposure and treatment outcomes, was evaluated retrospectively. The median survival time was estimated with the Kaplan-Meier method and the median follow-up period was estimated using the reverse Kaplan-Meier. Results: 1,965 oesophageal cancer patients were identified; 1,380(70.23%) were males and 585(29.77 %) females, their mean age was 60.20 years (±12.66). Most males had a history of both alcohol consumption and smoking 640(46.38%). The lower third of the oesophagus was the most common anatomical location 771(39.24%). The majority had squamous cell carcinoma histological type 1,783(90.74%) followed by adenocarcinomas 182(9.26%) in the distal oesophagus. Poorly differentiated tumour grade 743(37.81%) was predominant. The majority of the patients were in stage IVB, 733(37.30%), and most patients were planned for the best supportive care, 731(37.20%). Radiation alone was offered to 621(31.60%) and feeding gastrostomy to 249(12.70%). Treatment outcomes: at the time of the current analysis, 58.68% had died, 1.48% were alive and 39.84% were lost to follow-up. The median follow-up period was 65 months (IQR:35.83-83.30) with a median survival time of 4.47 months (95% CI: 4.17-4.80). Conclusion: Treatment outcomes of Ugandan oesophageal cancer patients seeking care are poor as most patients present with advanced disease. There is a significant loss of follow-up after treatment initiation. Therefore, reduction in exposure to known modifiable risk factors, early detection and timely referral for treatment strategies are needed to improve outcomes of these patients in our population. Designing interventions to improve treatment adherence is necessary.
Language	English
Publishing date	2023-07-19
Publishing country	England
Document type	Journal Article
ISSN	1754-6605
ISSN	1754-6605
DOI	10.3332/ecancer.2023.1576
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