Browsing by Author "Nambooze, Sarah"

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    Building capacity for geospatial cancer research in Uganda: a feasibility study
    (The Lancet Global Health, 2019) Beyer, Kirsten; Lukande, Robert; Kasasa, Simon; Kavanya, Gray; Nambooze, Sarah; Amulen, Phoebe; Cassidy, Laura; Tumwesigye, Nazarius; Babikako, Harriet; Anguzu, Ronald; Oyana, Tonny; Wabinga, Henry
    There is a growing epidemic of cancer and other non-communicable diseases in sub-Saharan Africa. Targeted, specific, cost-effective strategies are needed to manage the growing burden of cancer. In high-resource settings, geospatial analysis has transformed cancer control through geographic targeting of interventions and policies. A similar approach could improve cancer control in sub-Saharan Africa; however, georeferenced cancer data and increased geospatial research capacity are needed. Here, we aimed to assess the feasibility of geocoding and mapping small-area cancer data from a cancer registry in Uganda. We established a partnership including the Makerere University Department of Pathology, School of Public Health and College of Computing and Information Sciences, the Kampala Cancer Registry, Uganda, and the Medical College of Wisconsin, USA. The overarching goal of our multidisciplinary and multi-institutional partnership is to increase geospatial cancer research capacity at Makerere University to enhance the prioritisation and targeting of limited cancer prevention and control resources in Uganda. Two medical students from the Medical College of Wisconsin, mentored by faculty at their own institution and Makerere University, worked in Kampala with registry staff to identify, enter, and quality-check geographic codes of residence for approximately 1522 cervical cancer records from 2005 to 2014. Information about district (n=1520, 99·9%) and subcounty (n=1486, 97·6%) was available for the vast majority of cases, and the parish was identifiable for a large proportion of cases (n=1242, n=81·6%), with increasing availability in more recent years. A seed grant is supporting ongoing capacity building at the Kampala Cancer Registry, including the purchase of new computing hardware and software and the implementation of a revised geographic data collection protocol to support future geospatial analysis of Kampala Cancer Registry data.
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    High-resolution disease maps for cancer control in low-resource settings: A spatial analysis of cervical cancer incidence in Kampala, Uganda
    (Journal of Global Health, 2022) Beyer, Kirsten; Kasasa, Simon; Anguzu, Ronald; Lukande, Robert; Nambooze, Sarah; Nansereko, Brendah; Oyana, Tonny; Savino, Danielle; Feustel, Kavanya; Wabinga, Henry
    The global burden of cervical cancer is concentrated in low-and middle-income countries (LMICs), with the greatest burden in Africa. Targeting limited resources to populations with the greatest need to maximize impact is essential. The objectives of this study were to geocode cervical cancer data from a population-based cancer registry in Kampala, Uganda, to create high-resolution disease maps for cervical cancer prevention and control planning, and to share lessons learned to optimize efforts in other low-resource settings.
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    Parish level social factors predict population-based cervical cancer incidence in Kampala, Uganda, 2008–15: an ecological study
    (The Lancet Global Health, 2022) Beyer, Kirsten M M; Kasasa, Simon; Anguzu, Ronald; Nambooze, Sarah; Amulen, Phoebe Mary; Nansereko, Brendah; Zhou, Yuhong; Lukande, Robert; Wabinga, Henry
    The burden of cancer in Africa is growing. Although cancer outcomes are understood as the product of influences at multiple socioecological levels, population-based studies of geographical factors and cancer outcomes in Africa are scarce. The objective of this study was to identify parish-level social factors associated with cervical cancer incidence in the Kampala Cancer Registry catchment area, using a novel linkage between population-based cancer registry data and small-area census data from Uganda. Kampala Cancer Registry cervical cancer records (2008–15) were augmented to add the parish of residence at diagnosis. Parish-level population and housing profile data (2014) were obtained from the Uganda Bureau of Statistics and linked to Kampala Cancer Registry records. Stepwise forward Poisson regression modelling was used to estimate incidence ratios (IR) assessing associations between social factors and incidence. Housing tenure, infrastructure, gender equality, economic status, and employment were examined, controlling for population density. The significance level was set at α=0·05. Factors related to higher incidence included a higher girl-to-boy ratio of 6–12-year-olds not attending school (IR 1·33 [95% CI 1·15–1·54]; p<0.001), a higher percentage of 10–17-year-olds ever married (IR 1·22 [95% CI 1·06–1·40]; p=0·006) and a higher percentage of households receiving remittances (IR 1·03 [95% CI 1·00–1·06]; p=0·026). Factors associated with lower incidence included a higher percentage of household owner occupancy (IR 0·95 [95% CI 0·92–0·98]; p=0·002) and a higher percentage of households with piped water (IR 0·97 [95% CI 0·95–0·99]; p=0·009). Interpretation Parish-level social factors predict cervical cancer incidence in Uganda. Communities most at risk are characterised by inequity in educational access for girls, higher prevalence of child marriage, low home ownership, inadequate infrastructure, and financial dependence. These communities would benefit from HPV vaccination and screening campaigns to prevent and control cervical cancer. Investments should be made to enhance population-based cancer surveillance and census data collection in Africa to offer new strategies and targets for cancer prevention and control.
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    Survival from childhood cancer in Kampala, Uganda
    (Wiley Subscription Services, Inc, 2021-03) Liu, Biying; Youlden, Danny R; Wabinga, Henry; Nambooze, Sarah; Amulen, Phoebe Mary; Aitken, Joanne F; Parkin, Donald Maxwell
    Abstract Population-based data on survival from childhood cancers in sub-Saharan Africa are sparse.We report data on 221 children with cancer diagnosed between 2010 and 2014 in the population of Kampala, Uganda. Survival for eight of nine children with cancer assessed was below the WHO’s global target of 60% (the exception was Hodgkin lymphoma: 86% at 3 years). There was significant (P < .05) decline in survival between 1 and 3 years for Wilms tumour and Kaposi sarcoma (30% and 34% at 3 years, respectively). Survival from Burkitt lymphoma, Wilms tumour and Kaposi sarcoma has not changed compared with results from the 2005-2009 study
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    Uganda experience—Using cost assessment of an established registry to project resources required to expand cancer registration
    (Cancer epidemiology, 2016) Wabinga, Henry; Subramanian, Sujha; Nambooze, Sarah; Mary Amulen, Phoebe; Edwards, Patrick; Joseph, Rachael; Ogwang, Martin; Okongo, Francis; Parkin, D. Maxwell; Tangka, Florence
    The objectives of this study are (1) to estimate the cost of operating the Kampala Cancer Registry (KCR) and (2) to use cost data from the KCR to project the resource needs and cost of expanding and sustaining cancer registration in Uganda, focusing on the recently established Gulu Cancer Registry (GCR) in rural Northern Uganda. Methods: We used Centers for Disease Control and Prevention’s (CDC’s) International Registry Costing Tool (IntRegCosting Tool) to estimate the KCR’s activity-based cost for 2014. We grouped the registry activities into fixed cost, variable core cost, and variable other cost activities. After a comparison KCR and GCR characteristics, we used the cost of the KCR to project the likely ongoing costs for the new GCR. Results: The KCR incurred 42% of its expenditures in fixed cost activities, 40% for variable core cost activities, and the remaining 18% for variable other cost activities. The total cost per case registered was 28,201 Ugandan shillings (approximately US $10 in 2014) to collect and report cases using a combination of passive and active cancer data collection approaches. The GCR performs only active data collection, and covers a much larger area, but serves a smaller population compared to the KCR. Conclusion: After identifying many differences between KCR and GCR that could potentially affect the cost of registration, our best estimate is that the GCR, though newer and in a rural area, should require fewer resources than the KCR to sustain operations as a stand-alone entity. The optimal structure of the GCR needs to be determined in the future.