18 April 2019

Tanzania: Experts Push for Improvement of Referral Pattern

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(file photo).

HEALTH practitioners have recommended the improvement of the country's referral pattern to facilitate earlier diagnosis of breast cancer.

According to statistics, approximately 80 per cent of women diagnosed with breast cancer in the country are examined at advanced stages III and IV where treatment is less effective and outcomes are poor.

Deputy Executive Director of Muhimbili National Hospital-Mloganzila, Dr Julieth Magandi said recently that the referral pattern has been a big challenge towards improving breast cancer treatment in the country.

"Our referral pattern is a serious challenge to us if we really want to detect breast cancer at early stages...the only advantageous patients are those residing in Dar es Salaam, Mwanza and Kilimanjaro," said Dr Magandi who is also a general surgeon.

She said the journey from primary health care to the national hospital is very long, leading to patient being diagnosed at critical stages.

Dr Magandi detailed that data from Buganda Referral Hospital, Muhimbili National Hospital and Ocean Road Cancer Institute indicate that most of cancer cases presented to the hospitals were at advanced stages.

In 2014, about 60 per cent of cancer cases reported at Bugando hospital were in stages III and IV while in 2010, about 80 of all reported cancer cases at Ocean Road and Muhimbili were in stages III and IV, with only one per cent in stage one and 9.2 in stage II.

She noted that the oneyear data for between July 2012 and June 2013 from MNH department of surgery showed that out of 856 patients who were operated, 20 per cent were breast surgeries.

Dr Magandi clarified that of all breast surgeries, 15 per cent was breast cancer surgeries most of them being mastectomy. "If at all we had breast conserving surgery, there would be one or two cases."

She further said that apart from improving referral pattern, there was also need to advocate health awareness among both community and healthcare workers.

"There should be effective training to health care providers at all levels and establish breast care unit in our faculties if we want to have quality healthcare for our breast cancer patients," she noted.

She added: "If we lack well trained people, we will not actually reach where we want to go in providing care for breast cancer patients," Dr Magandi said breast cancer was the most common cause of cancer deaths among women worldwide, representing 25 to 35 per cent of all female cancer cases.

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