St. Kizito – Mikumi Hospital & Bristol Myers Squibb Foundation
St. Kizito – Mikumi Hospital
St. Kizito – Mikumi Hospital was granted $481,096 over 3 years to develop a model for HIV/NCD integration in order to reduce the mortality rates due cervical cancer, breast cancer and tuberculosis and prevent complication from diabetes and hypertension among people living with HIV in the Kilosa District, Morogoro Region, Tanzania.
Need
Tanzania has one of highest cervical cancer burdens in the world, and the highest in Eastern Africa with an age-standardized incidence rate (ASR) of 50.9 cases per 100,000 women. More specifically, in Morogoro Region (according to a study carried out at Morogoro Regional Referral Hospital), of all VIA/VILI screened positive women, 58 (47.9%) were in the age group between 30 and 39 years and 42 (34.7%) women were in the age group between 40 and 49 years.
In the two district Hospitals (St-Kizito Mikumi Hospital and Kilosa Governmental Hospital), breast cancer is not diagnosed or identified early. It is usually only detected at its latest stages. In Tanzania, non-communicable diseases (NCDs) are estimated to account for about 30% of all deaths in 2015 (cardiovascular diseases-9%, cancers-5%, diabetes-2%, chronic respiratory disease-1%, and NCDs-13%). It has been estimated that by 2020 NCDs will cause three quarters as many deaths as communicable, maternal, perinatal and nutritional diseases, and that by 2030 NCDs will become the most common causes of deaths.
Stroke has been described as an emerging problem in Tanzania. It is poorly known among the communities. Hypertension, which is prevalent in these communities, is a major risk factor for stroke. The risk factors and mortality rates shed light on the need for improvement of the delivery of NCD services, especially in the rural areas. Here, fully integrated screening and treatment programs are needed.
In an on-going project funded by BMSF implemented by Doctors with Africa CUAMM, cervical cancer screening and treatment (cryotherapy) service is now available at St. Kizito Mikumi Hospital and in four health centers. LEEP (Loop Electro surgery Excision Procedure) services are about to be introduced. Data from the on-going BMSF project are encouraging: in the first year 3.809 women were screened for cervical cancer and 119 of them, having pre-cancerous lesions, were treated with cryotherapy. Five women with advanced cancerous lesions underwent LEEP at a referral hospital.
A recent household-based Knowledge, Attitude and Practice (KAP) survey coupled with qualitative focus group discussions, implemented by Doctors with Africa Cuamm within the framework of the on-going project funded by BMSF, found that besides high awareness of cervical cancer (78%) and breast cancer (67), few respondents (18%) are aware that cervical cancer has signs or symptoms in its early stages. Respondents with no children have worse cervical cancer knowledge levels and practices compared to those with children. The adolescent age group (15-19 years) has the lowest proportion of respondents who have ever heard of cervical cancer.
Project
This project seek to leverage HIV care and support resources by integrating screening and primary care services to prevent NCDs with a special focus on cervical and breast cancers. The goal is to reduce mortality rates due cervical cancer, breast cancer and tuberculosis and prevent complication from diabetes and hypertension, among the people living with HIV.
St Kizito – Mikumi Hospital hopes to increase awareness of NCDs especially among women of childbearing age and those living with HIV.
Partners
- Doctors with Africa CUAMM
- PRRR in Tanzania