An evaluation of the disparities affecting the underdiagnosis of pediatric cancer in Western Kenya.

INTRODUCTION: Western Kenya is home to approximately 24 million people, with 10 million children under the age of 15 years.1 Based on estimates of cancer incidence in similar populations from around the world, approximately 1500 patients should be diagnosed with pediatric cancer each year. This article describes the international collaboration that investigates potential barriers preventing the effective diagnosis of pediatric patients with cancer. METHODS: Here, we describe a multidisciplinary and sequential approach to better evaluate the complex factors affecting the lack of appropriate diagnosis of pediatric cancer in Western Kenya. RESULTS: Internal review at a large tertiary hospital noted 200-250 patients were diagnosed annually, suggesting the remaining 75%-80% of patients go undiagnosed and do not receive treatment. Following our screening process at a local referring hospital, 41 malaria slides demonstrated both morphologic and genetic evidence of leukemia. Knowledge assessments of local providers at referring institutions suggested a lack of education and training as the factors that contribute to lower rates of diagnosis. DISCUSSION: Through a multi-step approach, our teams were better able to isolate potential issues impeding the appropriate and timely diagnosis of pediatric cancer in Kenya.

Towards a unified approach for multiple myeloma care in Kenya - proceedings of the Inaugural Multiple Myeloma Congress.

The rising burden of multiple myeloma in Kenya has not been met by a commensurate effort for control. Patients and practitioners struggle with unavailability and unaffordability of diagnostics, drugs and stem cell transplant leading to presentation at advanced stages and under-treatment with increased morbidities and mortality. A concerted effort among stakeholders is urgently needed to develop strategies for myeloma control. The scarcity of providers also carries grave consequences for Kenyan patients. The Academic Model Providing Access To Healthcare (AMPATH) multiple myeloma program organized the Inaugural Virtual Multiple Myeloma Congress to achieve both interactive specialist instruction and stakeholder engagement. Expert presenters and panellists from diverse disciplines were invited to offer in-depth presentations on myeloma care and case studies from panellists´ practice were used to contextualize learning points and form a basis for generating debate on the challenges facing providers and opportunities for care improvement. An audience of health professionals offering care to myeloma patients was invited. The underlying principle of recommendations developed during the congress was collaboration among in-country and international practitioners, researchers and policy experts from private and public sector. This partnership of stakeholders bears the potential of pooling scarce resources and for collective advocacy towards better patient care.

Carica papaya seed enhances phytochemicals and functional properties in cornmeal porridges.

Papaya seeds, a high source of dietary nutrients and phytochemicals are wasted when Carica papaya fruit is processed and consumed. This study investigates bioactivity of papaya seeds (PS) from 3 different locations in Kenya for potential valorization as porridge. PS was treated with acetic acid and sodium bicarbonate to improve pallatability. HPLC analysis revealed that PS flour added compounds which were absent from cornmeal (p-hydroxybenzoic, 2,4-dihydroxybenzoic and vanillic acids) and increased over 25% the pre-existing ones. Acid and alkali treatments increased the phenolic compounds content and antioxidant capacities of the seed 1 porridges in ≈19% average. The differential scanning calorimetry and the rapid visco analysis showed a significant decrease in the enthalpy required (≈44%) to gelatinize cornmeal-PS blend and the tendency for retrogradation (from 2188 to 700 cP average). Therefore, our findings indicate that PS can contribute to improved phytochemical and functional properties of cornmeal porridges.