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Nzitakera A, Surwumwe JB, Ndoricyimpaye EL, Uwamungu S, Uwamariya D, Manirakiza F, Ndayisaba MC, Ntakirutimana G, Seminega B, Dusabejambo V, Rutaganda E, Kamali P, Ngabonziza F, Ishikawa R, Rugwizangoga B, Iwashita Y, Yamada H, Yoshimura K, Sugimura H, Shinmura K. Correction: The spectrum of TP53 mutations in Rwandan patients with gastric cancer. Genes Environ 2024; 46:9. [PMID: 38566216 PMCID: PMC10986060 DOI: 10.1186/s41021-024-00303-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2024] Open
Affiliation(s)
- Augustin Nzitakera
- Department of Tumor Pathology, Hamamatsu University School of Medicine (HUSM), 1-20-1 Handayama, Higashi-Ku, 431-3192, Hamamatsu, Shizuoka, Japan
- Department of Biomedical Laboratory Sciences, School of Health Sciences, College of Medicine and Health Sciences, University of Rwanda, Kigali, P.O. Box 3286, Rwanda
| | - Jean Bosco Surwumwe
- Department of Pathology, University Teaching Hospital of Kigali, Kigali, P.O. Box 655, Rwanda
| | - Ella Larissa Ndoricyimpaye
- Department of Biomedical Laboratory Sciences, School of Health Sciences, College of Medicine and Health Sciences, University of Rwanda, Kigali, P.O. Box 3286, Rwanda
- Université Catholique de Louvain, Médecine Expérimentale, 1348, Brussels, Belgium
| | - Schifra Uwamungu
- Department of Biomedical Laboratory Sciences, School of Health Sciences, College of Medicine and Health Sciences, University of Rwanda, Kigali, P.O. Box 3286, Rwanda
- Department of Pharmacology, Sahlgrenska Academy, University of Gothenburg, SE-40530, Gothenburg, Sweden
| | - Delphine Uwamariya
- Department of Biomedical Laboratory Sciences, School of Health Sciences, College of Medicine and Health Sciences, University of Rwanda, Kigali, P.O. Box 3286, Rwanda
- Department of Pathology, University Teaching Hospital of Kigali, Kigali, P.O. Box 655, Rwanda
- Department of Pathology, School of Medicine and Pharmacy, College of Medicine and Health Sciences, University of Rwanda, Kigali, P.O. Box 3286, Rwanda
| | - Felix Manirakiza
- Department of Tumor Pathology, Hamamatsu University School of Medicine (HUSM), 1-20-1 Handayama, Higashi-Ku, 431-3192, Hamamatsu, Shizuoka, Japan
- Department of Pathology, University Teaching Hospital of Kigali, Kigali, P.O. Box 655, Rwanda
- Department of Pathology, School of Medicine and Pharmacy, College of Medicine and Health Sciences, University of Rwanda, Kigali, P.O. Box 3286, Rwanda
| | - Marie Claire Ndayisaba
- Department of Pathology, University Teaching Hospital of Kigali, Kigali, P.O. Box 655, Rwanda
- Department of Pathology, School of Medicine and Pharmacy, College of Medicine and Health Sciences, University of Rwanda, Kigali, P.O. Box 3286, Rwanda
| | - Gervais Ntakirutimana
- Department of Pathology, University Teaching Hospital of Kigali, Kigali, P.O. Box 655, Rwanda
- Department of Pathology, School of Medicine and Pharmacy, College of Medicine and Health Sciences, University of Rwanda, Kigali, P.O. Box 3286, Rwanda
| | - Benoit Seminega
- Department of Pathology, School of Medicine and Pharmacy, College of Medicine and Health Sciences, University of Rwanda, Kigali, P.O. Box 3286, Rwanda
- Department of Internal Medicine, University Teaching Hospital of Kigali, Kigali, P.O. Box 655, Rwanda
| | - Vincent Dusabejambo
- Department of Pathology, School of Medicine and Pharmacy, College of Medicine and Health Sciences, University of Rwanda, Kigali, P.O. Box 3286, Rwanda
- Department of Internal Medicine, University Teaching Hospital of Kigali, Kigali, P.O. Box 655, Rwanda
| | - Eric Rutaganda
- Department of Pathology, School of Medicine and Pharmacy, College of Medicine and Health Sciences, University of Rwanda, Kigali, P.O. Box 3286, Rwanda
- Department of Internal Medicine, University Teaching Hospital of Kigali, Kigali, P.O. Box 655, Rwanda
| | - Placide Kamali
- Department of Pathology, School of Medicine and Pharmacy, College of Medicine and Health Sciences, University of Rwanda, Kigali, P.O. Box 3286, Rwanda
- Department of Internal Medicine, University Teaching Hospital of Kigali, Kigali, P.O. Box 655, Rwanda
| | - François Ngabonziza
- Department of Pathology, School of Medicine and Pharmacy, College of Medicine and Health Sciences, University of Rwanda, Kigali, P.O. Box 3286, Rwanda
- Department of Internal Medicine, University Teaching Hospital of Kigali, Kigali, P.O. Box 655, Rwanda
| | - Rei Ishikawa
- Department of Tumor Pathology, Hamamatsu University School of Medicine (HUSM), 1-20-1 Handayama, Higashi-Ku, 431-3192, Hamamatsu, Shizuoka, Japan
| | - Belson Rugwizangoga
- Department of Pathology, University Teaching Hospital of Kigali, Kigali, P.O. Box 655, Rwanda
- Department of Pathology, School of Medicine and Pharmacy, College of Medicine and Health Sciences, University of Rwanda, Kigali, P.O. Box 3286, Rwanda
| | - Yuji Iwashita
- Department of Tumor Pathology, Hamamatsu University School of Medicine (HUSM), 1-20-1 Handayama, Higashi-Ku, 431-3192, Hamamatsu, Shizuoka, Japan
| | - Hidetaka Yamada
- Department of Tumor Pathology, Hamamatsu University School of Medicine (HUSM), 1-20-1 Handayama, Higashi-Ku, 431-3192, Hamamatsu, Shizuoka, Japan
| | - Kimio Yoshimura
- Department of Health Policy and Management, Keio University School of Medicine, 160-8582, Tokyo, Japan
| | - Haruhiko Sugimura
- Department of Tumor Pathology, Hamamatsu University School of Medicine (HUSM), 1-20-1 Handayama, Higashi-Ku, 431-3192, Hamamatsu, Shizuoka, Japan.
- Sasaki Institute Sasaki Foundation, 2-2 Kanda Surugadai, Chiyoda-Ku, 101-0062, Tokyo, Japan.
| | - Kazuya Shinmura
- Department of Tumor Pathology, Hamamatsu University School of Medicine (HUSM), 1-20-1 Handayama, Higashi-Ku, 431-3192, Hamamatsu, Shizuoka, Japan.
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Nzitakera A, Surwumwe JB, Ndoricyimpaye EL, Uwamungu S, Uwamariya D, Manirakiza F, Ndayisaba MC, Ntakirutimana G, Seminega B, Dusabejambo V, Rutaganda E, Kamali P, Ngabonziza F, Ishikawa R, Rugwizangoga B, Iwashita Y, Yamada H, Yoshimura K, Sugimura H, Shinmura K. The spectrum of TP53 mutations in Rwandan patients with gastric cancer. Genes Environ 2024; 46:8. [PMID: 38459566 PMCID: PMC10921722 DOI: 10.1186/s41021-024-00302-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Accepted: 02/18/2024] [Indexed: 03/10/2024] Open
Abstract
BACKGROUND Gastric cancer is the sixth most frequently diagnosed cancer and third in causing cancer-related death globally. The most frequently mutated gene in human cancers is TP53, which plays a pivotal role in cancer initiation and progression. In Africa, particularly in Rwanda, data on TP53 mutations are lacking. Therefore, this study intended to obtain TP53 mutation status in Rwandan patients with gastric cancer. RESULTS Formalin-fixed paraffin-embedded tissue blocks of 95 Rwandan patients with histopathologically proven gastric carcinoma were obtained from the University Teaching Hospital of Kigali. After DNA extraction, all coding regions of the TP53 gene and the exon-intron boundary region of TP53 were sequenced using the Sanger sequencing. Mutated TP53 were observed in 24 (25.3%) of the 95 cases, and a total of 29 mutations were identified. These TP53 mutations were distributed between exon 4 and 8 and most of them were missense mutations (19/29; 65.5%). Immunohistochemical analysis for TP53 revealed that most of the TP53 missense mutations were associated with TP53 protein accumulation. Among the 29 mutations, one was novel (c.459_477delCGGCACCCGCGTCCGCGCC). This 19-bp deletion mutation in exon 5 caused the production of truncated TP53 protein (p.G154Wfs*10). Regarding the spectrum of TP53 mutations, G:C > A:T at CpG sites was the most prevalent (10/29; 34.5%) and G:C > T:A was the second most prevalent (7/29; 24.1%). Interestingly, when the mutation spectrum of TP53 was compared to three previous TP53 mutational studies on non-Rwandan patients with gastric cancer, G:C > T:A mutations were significantly more frequent in this study than in our previous study (p = 0.013), the TCGA database (p = 0.017), and a previous study on patients from Hong Kong (p = 0.006). Even after correcting for false discovery, statistical significance was observed. CONCLUSIONS Our results suggested that TP53 G:C > T:A transversion mutation in Rwandan patients with gastric cancer is more frequent than in non-Rwandan patients with gastric cancer, indicating at an alternative etiological and carcinogenic progression of gastric cancer in Rwanda.
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Affiliation(s)
- Augustin Nzitakera
- Department of Tumor Pathology, Hamamatsu University School of Medicine (HUSM), 1-20-1 Handayama, Higashi-Ku, Hamamatsu, Shizuoka, 431-3192, Japan
- Department of Biomedical Laboratory Sciences, School of Health Sciences, College of Medicine and Health Sciences, University of Rwanda, P.O. Box 3286, Kigali, Rwanda
| | - Jean Bosco Surwumwe
- Department of Pathology, University Teaching Hospital of Kigali, P.O. Box 655, Kigali, Rwanda
| | - Ella Larissa Ndoricyimpaye
- Department of Biomedical Laboratory Sciences, School of Health Sciences, College of Medicine and Health Sciences, University of Rwanda, P.O. Box 3286, Kigali, Rwanda
- Université Catholique de Louvain, Médecine Expérimentale, Brussels, 1348, Belgium
| | - Schifra Uwamungu
- Department of Biomedical Laboratory Sciences, School of Health Sciences, College of Medicine and Health Sciences, University of Rwanda, P.O. Box 3286, Kigali, Rwanda
- Department of Pharmacology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, SE-40530, Sweden
| | - Delphine Uwamariya
- Department of Biomedical Laboratory Sciences, School of Health Sciences, College of Medicine and Health Sciences, University of Rwanda, P.O. Box 3286, Kigali, Rwanda
- Department of Pathology, University Teaching Hospital of Kigali, P.O. Box 655, Kigali, Rwanda
- Department of Pathology, School of Medicine and Pharmacy, College of Medicine and Health Sciences, University of Rwanda, P.O. Box 3286, Kigali, Rwanda
| | - Felix Manirakiza
- Department of Tumor Pathology, Hamamatsu University School of Medicine (HUSM), 1-20-1 Handayama, Higashi-Ku, Hamamatsu, Shizuoka, 431-3192, Japan
- Department of Pathology, University Teaching Hospital of Kigali, P.O. Box 655, Kigali, Rwanda
- Department of Pathology, School of Medicine and Pharmacy, College of Medicine and Health Sciences, University of Rwanda, P.O. Box 3286, Kigali, Rwanda
| | - Marie Claire Ndayisaba
- Department of Pathology, University Teaching Hospital of Kigali, P.O. Box 655, Kigali, Rwanda
- Department of Pathology, School of Medicine and Pharmacy, College of Medicine and Health Sciences, University of Rwanda, P.O. Box 3286, Kigali, Rwanda
| | - Gervais Ntakirutimana
- Department of Pathology, University Teaching Hospital of Kigali, P.O. Box 655, Kigali, Rwanda
- Department of Pathology, School of Medicine and Pharmacy, College of Medicine and Health Sciences, University of Rwanda, P.O. Box 3286, Kigali, Rwanda
| | - Benoit Seminega
- Department of Pathology, School of Medicine and Pharmacy, College of Medicine and Health Sciences, University of Rwanda, P.O. Box 3286, Kigali, Rwanda
- Department of Internal Medicine, University Teaching Hospital of Kigali, P.O. Box 655, Kigali, Rwanda
| | - Vincent Dusabejambo
- Department of Pathology, School of Medicine and Pharmacy, College of Medicine and Health Sciences, University of Rwanda, P.O. Box 3286, Kigali, Rwanda
- Department of Internal Medicine, University Teaching Hospital of Kigali, P.O. Box 655, Kigali, Rwanda
| | - Eric Rutaganda
- Department of Pathology, School of Medicine and Pharmacy, College of Medicine and Health Sciences, University of Rwanda, P.O. Box 3286, Kigali, Rwanda
- Department of Internal Medicine, University Teaching Hospital of Kigali, P.O. Box 655, Kigali, Rwanda
| | - Placide Kamali
- Department of Pathology, School of Medicine and Pharmacy, College of Medicine and Health Sciences, University of Rwanda, P.O. Box 3286, Kigali, Rwanda
- Department of Internal Medicine, University Teaching Hospital of Kigali, P.O. Box 655, Kigali, Rwanda
| | - François Ngabonziza
- Department of Pathology, School of Medicine and Pharmacy, College of Medicine and Health Sciences, University of Rwanda, P.O. Box 3286, Kigali, Rwanda
- Department of Internal Medicine, University Teaching Hospital of Kigali, P.O. Box 655, Kigali, Rwanda
| | - Rei Ishikawa
- Department of Tumor Pathology, Hamamatsu University School of Medicine (HUSM), 1-20-1 Handayama, Higashi-Ku, Hamamatsu, Shizuoka, 431-3192, Japan
| | - Belson Rugwizangoga
- Department of Pathology, University Teaching Hospital of Kigali, P.O. Box 655, Kigali, Rwanda
- Department of Pathology, School of Medicine and Pharmacy, College of Medicine and Health Sciences, University of Rwanda, P.O. Box 3286, Kigali, Rwanda
| | - Yuji Iwashita
- Department of Tumor Pathology, Hamamatsu University School of Medicine (HUSM), 1-20-1 Handayama, Higashi-Ku, Hamamatsu, Shizuoka, 431-3192, Japan
| | - Hidetaka Yamada
- Department of Tumor Pathology, Hamamatsu University School of Medicine (HUSM), 1-20-1 Handayama, Higashi-Ku, Hamamatsu, Shizuoka, 431-3192, Japan
| | - Kimio Yoshimura
- Department of Health Policy and Management, Keio University School of Medicine, Tokyo, 160-8582, Japan
| | - Haruhiko Sugimura
- Department of Tumor Pathology, Hamamatsu University School of Medicine (HUSM), 1-20-1 Handayama, Higashi-Ku, Hamamatsu, Shizuoka, 431-3192, Japan.
- Sasaki Institute Sasaki Foundation, 2-2 Kanda Surugadai, Chiyoda-Ku, Tokyo, 101-0062, Japan.
| | - Kazuya Shinmura
- Department of Tumor Pathology, Hamamatsu University School of Medicine (HUSM), 1-20-1 Handayama, Higashi-Ku, Hamamatsu, Shizuoka, 431-3192, Japan.
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Manirakiza F, Rutaganda E, Yamada H, Iwashita Y, Rugwizangoga B, Seminega B, Dusabejambo V, Ntakirutimana G, Ruhangaza D, Uwineza A, Shinmura K, Sugimura H. Clinicopathological Characteristics and Mutational Landscape of APC, HOXB13, and KRAS among Rwandan Patients with Colorectal Cancer. Curr Issues Mol Biol 2023; 45:4359-4374. [PMID: 37232746 DOI: 10.3390/cimb45050277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 04/24/2023] [Accepted: 05/11/2023] [Indexed: 05/27/2023] Open
Abstract
Cancer research in Rwanda is estimated to be less than 1% of the total African cancer research output with limited research on colorectal cancer (CRC). Rwandan patients with CRC are young, with more females being affected than males, and most patients present with advanced disease. Considering the paucity of oncological genetic studies in this population, we investigated the mutational status of CRC tissues, focusing on the Adenomatous polyposis coli (APC), Kirsten rat sarcoma (KRAS), and Homeobox B13 (HOXB13) genes. Our aim was to determine whether there were any differences between Rwandan patients and other populations. To do so, we performed Sanger sequencing of the DNA extracted from formalin-fixed paraffin-embedded adenocarcinoma samples from 54 patients (mean age: 60 years). Most tumors were located in the rectum (83.3%), and 92.6% of the tumors were low-grade. Most patients (70.4%) reported never smoking, and 61.1% of patients had consumed alcohol. We identified 27 variants of APC, including 3 novel mutations (c.4310_4319delAAACACCTCC, c.4463_4470delinsA, and c.4506_4507delT). All three novel mutations are classified as deleterious by MutationTaster2021. We found four synonymous variants (c.330C>A, c.366C>T, c.513T>C, and c.735G>A) of HOXB13. For KRAS, we found six variants (Asp173, Gly13Asp, Gly12Ala, Gly12Asp, Gly12Val, and Gln61His), the last four of which are pathogenic. In conclusion, here we contribute new genetic variation data and provide clinicopathological information pertinent to CRC in Rwanda.
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Affiliation(s)
- Felix Manirakiza
- Department of Pathology, College of Medicine and Health Sciences, University of Rwanda, Kigali P.O. Box 3286, Rwanda
- Department of Pathology, University Teaching Hospital of Kigali, Kigali P.O. Box 655, Rwanda
- Department of Tumor Pathology, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-Ku, Shizuoka 431-3192, Japan
| | - Eric Rutaganda
- Department of Internal Medicine, University Teaching Hospital of Kigali, Kigali P.O. Box 655, Rwanda
| | - Hidetaka Yamada
- Department of Tumor Pathology, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-Ku, Shizuoka 431-3192, Japan
| | - Yuji Iwashita
- Department of Tumor Pathology, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-Ku, Shizuoka 431-3192, Japan
| | - Belson Rugwizangoga
- Department of Pathology, College of Medicine and Health Sciences, University of Rwanda, Kigali P.O. Box 3286, Rwanda
- Department of Pathology, University Teaching Hospital of Kigali, Kigali P.O. Box 655, Rwanda
| | - Benoit Seminega
- Department of Internal Medicine, University Teaching Hospital of Kigali, Kigali P.O. Box 655, Rwanda
| | - Vincent Dusabejambo
- Department of Internal Medicine, University Teaching Hospital of Kigali, Kigali P.O. Box 655, Rwanda
| | - Gervais Ntakirutimana
- Department of Pathology, University Teaching Hospital of Kigali, Kigali P.O. Box 655, Rwanda
| | | | - Annette Uwineza
- Department of Pathology, University Teaching Hospital of Kigali, Kigali P.O. Box 655, Rwanda
- Department of Biochemistry, Molecular Biology and Genetics, College of Medicine and Health Sciences, University of Rwanda, Kigali P.O. Box 3286, Rwanda
| | - Kazuya Shinmura
- Department of Tumor Pathology, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-Ku, Shizuoka 431-3192, Japan
| | - Haruhiko Sugimura
- Department of Tumor Pathology, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-Ku, Shizuoka 431-3192, Japan
- Sasaki Institute Sasaki Foundation, 2-2 Kanda Surugadai, Chiyoda-Ku, Tokyo 101-0062, Japan
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Natsume H, Szczepaniak K, Yamada H, Iwashita Y, Gędek M, Šuto J, Kasajima R, Manirakiza F, Nzitakera A, Ishikawa R, Rutaganda E, Ngabonziza F, Seminega B, Kamali P, Dusabejambo V, Rugwizangoga B, Nobuhito N, Wang Y, Miyagi Y, Gurzu S, Sugimura H. Abstract 2609: Non-CpG sites preference in G:C>A:T transition of TP53 in gastric cancer of Eastern Europe (Poland, Romania and Hungary) compared to East Asian countries (China and Japan) : gastric cancer in the world, mutation spectrum revisited. Cancer Res 2023. [DOI: 10.1158/1538-7445.am2023-2609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/07/2023]
Abstract
Abstract
Aim: Mutation spectrum of TP53 in gastric cancer (GC) has been investigated world-widely, but a comparison of mutation spectrum among GCs from various regions in the world are still sparsely documented. In order to identify the difference of TP53 mutation spectrum in GCs in Eastern Europe and in East Asia, we sequenced TP53 in GCs from Eastern Europe, Lujiang (China), and Yokohama, Kanagawa (Japan) and identified the feature of TP53 mutations of GC in these regions.
Subjects and Method: In total, 689 tissue samples of GC were analyzed: 288 samples from East European populations (25 from Hungary, 71 from Poland and 192 from Romania), 268 from Yokohama, Kanagawa, Japan and 133 from Lujiang, Anhui province, China. DNA was extracted from FFPE tissue of Chinese, East European cases; and from frozen tissue of Japanese GCs. PCR products were direct-sequenced by Sanger method, and in ambiguous cases, PCR product was cloned and up to 8 clones were sequenced. We used No. NC_000017.11(hg38) as the reference sequence of TP53. Mutation patterns were categorized into nine groups: six base substitutions, insertion, deletion and deletion-insertion. Within G:C>A:T mutations the mutations in CpG and non-CpG sites were divided. Furthermore, 40 cases of Rwanda GC were compared in the world for mutation spectrum. The Cancer Genome Atlas data (TCGA, ver.R20, July, 2019) having somatic mutation list of GCs from Whites, Asians, and other ethnicities were used as a reference for our data.
Results: The most frequent base substitutions were G:C>A:T transition in all the areas investigated. The G:C>A:T transition in non-CpG sites were prominent in East European GCs, compared with Asian ones. Mutation pattern from TCGA data revealed the same trend between GCs from White (TCGA category) vs Asian countries. Chinese and Japanese GCs showed higher ratio of G:C>A:T transition in CpG sites and A:T>G:C mutation was more prevalent in Asian countries.
Conclusion: The divergence in mutation spectrum of GC in different areas in the world may reflect various pathogeneses and etiologies of GC, region to region. Diversified mutation spectrum in GC in Eastern Europe may suggest GC in Europe has different carcinogenic pathway of those from Asia. Whether the Rwanda pattern belong to Asian or East European would be interesting.
Citation Format: Hiroko Natsume, Kinga Szczepaniak, Hidetaka Yamada, Yuji Iwashita, Marta Gędek, Jelena Šuto, Rika Kasajima, Felix Manirakiza, Augustin Nzitakera, Rei Ishikawa, Eric Rutaganda, François Ngabonziza, Benoit Seminega, Placide Kamali, Vincent Dusabejambo, Belson Rugwizangoga, Nobuhito Nobuhito, Yaping Wang, Yohei Miyagi, Simona Gurzu, Haruhiko Sugimura. Non-CpG sites preference in G:C>A:T transition of TP53 in gastric cancer of Eastern Europe (Poland, Romania and Hungary) compared to East Asian countries (China and Japan) : gastric cancer in the world, mutation spectrum revisited [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 2609.
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Affiliation(s)
- Hiroko Natsume
- 1Hamamatsu University School of Medicine, Hamamatsu, Japan
| | | | | | - Yuji Iwashita
- 1Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Marta Gędek
- 3Medical University of Lublin, Lublin, Poland
| | - Jelena Šuto
- 4Clinical Hospital Centre Split, Split, Croatia
| | - Rika Kasajima
- 5Kanagawa Cancer Center Research Institute, Yokohama, Japan
| | | | | | - Rei Ishikawa
- 1Hamamatsu University School of Medicine, Hamamatsu, Japan
| | | | | | | | | | | | | | | | - Yaping Wang
- 7Nanjing University School of Medicine, Nanjing, China
| | - Yohei Miyagi
- 5Kanagawa Cancer Center Research Institute, Yokohama, Japan
| | - Simona Gurzu
- 8George Emil Palade University of Medicine, Pharmacy, Sciences and Technology, Targu Mures, Targu Mures, Romania
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Pyden A, Rugwizangoga B, Solomon IH, Laga AC. `Teaching Infectious Disease Pathology and Taking it To Africa. Mod Pathol 2023; 36:100168. [PMID: 36990280 DOI: 10.1016/j.modpat.2023.100168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 03/02/2023] [Accepted: 03/12/2023] [Indexed: 03/29/2023]
Abstract
With the advent of increasing emerging infectious diseases, rising antibiotic resistance, and the growing number of immunocompromised patients, there is increasing demand for infectious disease (ID) pathology expertise and microbiology testing. At present, infectious disease pathology training and emerging molecular microbiology techniques (e.g. metagenomic next-generation sequencing and whole genome sequencing) are not included in most American Council of Graduate Medical Education (ACGME) medical microbiology fellowship curricula, and, not surprisingly, many institutions lack anatomic pathologists with expertise in ID pathology and advanced molecular diagnostics. In this article, we describe the curriculum and structure of the Franz von Lichtenberg Fellowship in Infectious Disease and Molecular Microbiology at Brigham and Women's Hospital in Boston, MA. We emphasize the value of a training model that strives to integrate anatomic pathology, clinical pathology, and molecular pathology by providing examples in a case-based format and presenting selected metrics of the potential impact of such integrative infectious disease pathology service, and briefly describing opportunities and challenges of our global health efforts in Rwanda.
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Manirakiza F, Niyoyita JP, Habanabakize T, Ndagijimana E, Surwumwe JB, Rugwizangoga B. The use of Vsee videoconferencing for live telepathology in Rwanda, a potential solution for resource-limited area. Digit Health 2023; 9:20552076231159184. [PMID: 36860909 PMCID: PMC9969432 DOI: 10.1177/20552076231159184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 02/04/2023] [Indexed: 02/26/2023] Open
Abstract
Objective The shortage of pathologists is a worldwide problem that is more severe in Africa. One of the solutions is the use of telepathology (TP); however, most of the TP systems are expensive and unaffordable in many developing countries. At the University Teaching Hospital of Kigali, Rwanda, we assessed the possibility of combining commonly available laboratory tools into a system that can be used for diagnostic TP using Vsee videoconferencing. Methodology Using an Olympus microscope (with a camera) operated by a laboratory technologist, histologic images were transmitted to a computer whose screen was shared, using Vsee, with a remotely located pathologist who made the diagnoses. Sixty consecutive small biopsies (≤6 glass slides) from different tissues were examined to make a diagnosis using live Vsee-based videoconferencing TP. Vsee-based diagnoses were compared to pre-existing light microscopy-based diagnoses. Percent agreement and unweighted Cohen's kappa coefficient of the agreement were calculated. Results For agreement between conventional microscopy-based and Vsee-based diagnoses, we found an unweighted Cohen's kappa of 0.77 ± 0.07SE with a 95% CI of 0.62-0.91. The perfect percent agreement was 76.6% (46 of 60). Agreement with minor discrepancy was 15% (9 of 60). There were 2 cases of major discrepancy (3.30%). We were unable to make a diagnosis in 3 cases (5%) because of poor image quality related to the instantaneous internet connectivity problems. Conclusion This system provided promising results. However, additional studies to assess other parameters which can affect its performance are needed before this system can be considered an alternative method of providing TP services in resource-limited settings.
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Affiliation(s)
- Felix Manirakiza
- Department of Pathology, School of Medicine and Pharmacy, College of
Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda,Department of Health Informatics, School of Public Health, College
of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda,Department of Pathology, University Teaching Hospital of Kigali,
Kigali, Rwanda,Felix Manirakiza, Department of Pathology,
University Teaching Hospital of Kigali (CHUK), KN 4 Ave, P.O. Box 655 Kigali,
Rwanda.
| | - Jean Paul Niyoyita
- Department of Health Informatics, School of Public Health, College
of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
| | - Thomas Habanabakize
- Department of Pathology, School of Medicine and Pharmacy, College of
Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
| | - Emmanuel Ndagijimana
- Department of Biostatistics, School of Public Health, College of
Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda,The African Center of Excellence in Data Science, College of
Business and Economics, University of Rwanda, Kigali, Rwanda
| | - Jean Bosco Surwumwe
- Department of Pathology, University Teaching Hospital of Kigali,
Kigali, Rwanda
| | - Belson Rugwizangoga
- Department of Pathology, School of Medicine and Pharmacy, College of
Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda,Department of Pathology, University Teaching Hospital of Kigali,
Kigali, Rwanda
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Hammond A, Rugwizangoga B, Stanford FC. Leveraging PEPFAR for HIV drug equity. Front Reprod Health 2023; 5:1105645. [PMID: 37152480 PMCID: PMC10160368 DOI: 10.3389/frph.2023.1105645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Accepted: 03/30/2023] [Indexed: 05/09/2023] Open
Affiliation(s)
- Alessandro Hammond
- Harvard University, Cambridge, MA, United States
- Division of Hematology/Oncology, Department of Pediatric Oncology, Boston Children's Hospital, Boston, MA, United States
| | - Belson Rugwizangoga
- Department of Pathology, School of Medicine and Pharmacy, University of Rwanda, Kigali, Rwanda
- Directorate of Research and Department of Pathology, University Teaching Hospital of Kigali, Kigali, Rwanda
| | - Fatima Cody Stanford
- Massachusetts General Hospital, MGH Weight Center, Department of Medicine-Division of Endocrinology-Neuroendocrine, Department of Pediatrics-Division of Endocrinology, Nutrition Obesity Research Center at Harvard (NORCH), Harvard Medical School, Boston, MA, United States
- Correspondence: Fatima Cody Stanford
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Ntirenganya F, Twagirumukiza JD, Bukibaruta G, Byiringiro F, Rugwizangoga B, Rulisa S. Predictors of molecular subtypes in women with breast cancer in Rwanda. rmj 2022. [DOI: 10.4314/rmj.v79i4.7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
INTRODUCTION: Breast cancer (BC) constitutes a major public health problem worldwide. It remains a major scientific, clinical and societal challenge, generally in Africa and particularly in Rwanda. The purpose of this study was to determine clinical and histopathological predictors of BC molecular subtypes in Rwandan women.METHODS: A retrospective cohort study including patients with histological confirmation of BC. Using R statistical software, a regression model for multinomial responses was developed. Univariate and multivariate logistic regression analyses were used to identify independent BC molecular subtypes predictors. A two-sided p<0.05 indicated a statistically significant difference.RESULTS: Forty seven percent of cases presented with advanced stages (Stage III and IV). Postmenopausal BC (p=0.0142), absence of infertility (p=0.018) predicted Luminal A subtype with a predictive accuracy of 0.65. Age (p=0.003), postmenopausal BC (p=0.005), absence of axillar lymph nodes (p= 0.008) and poorly differentiated tumor (p=0.012) were predictors for Luminal B subtype with a predictive accuracy of 0.86. Age (p=0.045), BMI (p=0.005), rapid progression (p=0.032), tumor size T2-T3 (p<0.001) were predictors of HER2-Enriched subtype with a predictive accuracy of 0.70. Age below 40 (p=0.005), painless mass (p=0.030), nodal involvement (p=0.008), Nottingham grade 3 (p<0.001) predicted Triple Negative tumors with a predictive accuracy of 0.71.CONCLUSION: Clinical and histopathological tumor characteristics can be used to predict BC molecular subtypes with acceptable accuracy. Further studies are needed to explore the possibility of developing a scoring system for clinical decision-making, especially in settings where immunohistochemistry testing is limited.
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Gafaranga JP, Manirakiza F, Ndagijimana E, Urimubabo JC, Karenzi ID, Muhawenayo E, Gashugi PM, Nyirasebura D, Rugwizangoga B. Knowledge, Barriers and Motivators to Cervical Cancer Screening in Rwanda: A Qualitative Study. Int J Womens Health 2022; 14:1191-1200. [PMID: 36072693 PMCID: PMC9443995 DOI: 10.2147/ijwh.s374487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 08/25/2022] [Indexed: 11/23/2022] Open
Abstract
Background Cervical cancer is a global public health problem with marked geographical disparity. High morbidity and mortality rates in developing countries are associated with low screening rates. In 2020, in Rwanda, 3.7 million women aged 15–59 years were at risk of developing cervical cancer, the most commonly diagnosed female cancer in Rwanda. Despite Rwanda being the first African country to vaccinate against human papilloma virus with a three-dose regimen vaccination coverage of nearly 93% in the target population of girls aged <15 years, and having established cervical cancer screening program, recent studies have found low screening rates. Our study sought to determine knowledge, motivators and barriers of cervical cancer screening. Methods We conducted a qualitative descriptive study; using focus group interview in an urban health facility (Muhima district hospital) and a rural health center (Nyagasambu health center) offering cervical screening services in Rwanda. Participants were women seeking these services and other women attending the health facility for any reason, and female staff working in these facilities. Interviews were recorded and transcribed, and data were analyzed using content analysis. Results Thirty women participated in focus group interview, with an average age of 39 years. Many of women showed knowledge about cervical cancer existence and prevention methods. However, fear for pain, lack of knowledge about screening, how and where the screening was done, and concern for privacy were recurring subthemes. Some participants also mentioned lack of health insurance as a barrier for cervical cancer screening. Conclusion Barriers to uptake cervical cancer screening services in Rwanda are related to poor information about cervical cancer and the importance of screening as well as non-adherence to medical insurance. Population sensitization through campaign and community outreach activities could have a positive impact on increasing the usage of cervical cancer screening in Rwanda.
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Affiliation(s)
- Jean Pierre Gafaranga
- Department of Psychiatry, School of Medicine and Pharmacy, University of Rwanda, Kigali, Rwanda
- Department of Psychiatry, University Teaching Hospital of Kigali, Kigali, Rwanda
- Correspondence: Jean Pierre Gafaranga, Department of Psychiatry, University of Rwanda, Kigali, Rwanda, Department of Psychiatry, University Teaching Hospital of Kigali, Kigali, Rwanda, Tel +250788224864, Email ;
| | - Felix Manirakiza
- Department of Clinical Biology, School of Medicine and Pharmacy, University of Rwanda, Kigali, Rwanda
- Department of Pathology, University Teaching Hospital of Kigali, Kigali, Rwanda
| | - Emmanuel Ndagijimana
- Department of Epidemiology and Biostatistics, School of Public Health, University of Rwanda, Kigali, Rwanda
| | | | | | | | | | | | - Belson Rugwizangoga
- Department of Clinical Biology, School of Medicine and Pharmacy, University of Rwanda, Kigali, Rwanda
- Department of Pathology, University Teaching Hospital of Kigali, Kigali, Rwanda
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10
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Rugwizangoga B, Niyikora N, Musabyimana A, Izimukwiye AI, Aurelius J, Martner A, Umubyeyi A. Experience and Perception of Patients and Healthcare Professionals on Acute Leukemia in Rwanda: A Qualitative Study. Cancer Manag Res 2022; 14:1923-1934. [PMID: 35720643 PMCID: PMC9200230 DOI: 10.2147/cmar.s362882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Accepted: 06/01/2022] [Indexed: 12/09/2022] Open
Abstract
Purpose To explore challenges associated with the timely diagnosis, therapy, and prognosis of acute leukemia in Rwanda. Methods This is a qualitative study using a phenomenological approach that involved patients, patients’ guardians, and healthcare professionals such as physicians from district hospitals and specialists from referral hospitals, as well as healthcare administrators. The primary data were collected from district and referral hospitals and central healthcare administration in Rwanda. The data were collected between July and October 2019. In-depth interviews were conducted, and thematic analysis was employed to interpret the results. Results We identified barriers to seeking healthcare such as (i) insufficient knowledge within the population may lead patients and their guardians to consult traditional healers before seeking qualified medical care, and (ii) financial constraints that preclude payment of healthcare fees or other out-of-pocket cost related to diagnosis and treatment. We also observed that the referral system is tedious and primary healthcare facilities lack the competence and resources for the necessary diagnostic practices. Both may further delay diagnosis and therapy. Accordingly, healthcare professionals at the referral hospitals stated that most patients were seen at an advanced stage of the disease. For the treatment of acute lymphoblastic leukemia (ALL), only chemotherapy is utilized in Rwanda, while bone marrow (BM) transplantation is not available. Palliation is the only available treatment for the vast majority of Rwandan acute myeloid leukemia (AML) patients. Conclusion ALL and AML are likely under-reported in Rwanda and diagnosis may be delayed, which may be explained by patient-related factors (lack of knowledge, financial constraints), a tedious referral system, and suboptimal diagnostic resources.
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Affiliation(s)
- Belson Rugwizangoga
- University Teaching Hospital of Kigali, School of Medicine and Pharmacy, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda.,TIMM Laboratory, Sahlgrenska Center for Cancer Research, Department of Infectious Diseases, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Narcisse Niyikora
- School of Public Health, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
| | - Angèle Musabyimana
- School of Public Health, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
| | | | - Johan Aurelius
- TIMM Laboratory, Sahlgrenska Center for Cancer Research, Department of Infectious Diseases, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Anna Martner
- TIMM Laboratory, Sahlgrenska Center for Cancer Research, Department of Infectious Diseases, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Aline Umubyeyi
- School of Public Health, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
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Byiringiro FM, Manirakiza F, Ruhangaza D, Muvunyi TZ, Rugwizangoga B. Pathology Characteristics of Lymphomas in Rwanda: A Retrospective Study. East Afr Health Res J 2022; 5:170-173. [PMID: 35036844 PMCID: PMC8751542 DOI: 10.24248/eahrj.v5i2.669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Accepted: 11/15/2021] [Indexed: 11/20/2022] Open
Abstract
Background: Lymphomas have been a global challenge for many decades and despite measures for prevention and management, the incidence continues to increase. There are two main categories, which are Non-Hodgkin's Lymphomas and Hodgkin's Lymphomas and most common etiologies are environmental, genetic alteration, radiation and some viruses. Objective: To describe pathology characteristics of lymphomas in Rwanda based on Hematoxylin and Eosin stained glass slides and immuno histo chemistry, and classify them according to clinical aggressiveness. Patients and Methods: We conducted a retrospective observational and descriptive study from January 2013 to December 2019. Lymphoma cases were retrieved together with relevant clinical and pathological information, and reviewed by independent pathologists. Histological diagnosis was classified according to the 2008 World Health Organization system in order to assign clinical aggressiveness of the lymphoma. Results: Three hundred and six lymphoma cases were enrolled. Males contributed to 57% of all reviewed case, and slightly over 50% were young aged ≤35 years. Approximately 191 (62%) of cases were nodal lymphomas. Approximately one fifth (18%) of lymphoma cases were HIV positive. Most 213(70%) cases were Non-Hodgkin's Lymphomas of aggressive forms 164(77%). Among 164 cases of aggressive Non-Hodgkin's Lymphomas, diffuse large B cell lymphoma was the leading subtype 91(55.5%), followed by solid lymphoblastic lymphoma 32(19.5%) and Burkitt lymphoma 17(10.4%). Among all Hodgkin lymphoma cases, 90(97%) were classical Hodgkin lymphomaof nodular sclerosis subtype. Hodgkin lymphoma patients were younger compared to Non-Hodgkin's Lymphomas patients (mean age of 24.78±16.3 years versus 38.6±22. 5years, p=.000). Conclusion: Substantial proportion of Lymphomapatients in Rwanda were also HIV positive. Interestingly, Non-Hodgkin's Lymphomas in Rwanda are predominated by the most aggressive forms, and these mostly affect a younger population. Optimal characterisation of such cases, using advanced methods, is recommended.
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Affiliation(s)
- Fiacre Mugabe Byiringiro
- Department of Clinical Biology, School of Medicine and Pharmacy, University of Rwanda, Kigali, Rwanda
| | - Felix Manirakiza
- Department of Clinical Biology, School of Medicine and Pharmacy, University of Rwanda, Kigali, Rwanda.,Department of Pathology, University Teaching Hospital of Kigali, Kigali, Rwanda
| | | | | | - Belson Rugwizangoga
- Department of Clinical Biology, School of Medicine and Pharmacy, University of Rwanda, Kigali, Rwanda.,Department of Pathology, University Teaching Hospital of Kigali, Kigali, Rwanda
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12
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Nizeyimana T, Rugwizangoga B, Manirakiza F, Laga AC. Occurrence of Helicobacter Pylori in Specimens of Chronic Gastritis and Gastric Adenocarcinoma Patients: A Retrospective Study at University Teaching Hospital, Kigali, Rwanda. East Afr Health Res J 2022; 5:159-163. [PMID: 35036842 PMCID: PMC8751541 DOI: 10.24248/eahrj.v5i2.667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Accepted: 11/13/2021] [Indexed: 11/22/2022] Open
Abstract
Introduction: Helicobacter pylori (H. pylori) infection is the major cause of gastroduodenal diseases in populations of different ages. We conducted aretrospective studyusing archived tissue samples to determine the prevalence of H. pylori infection among patients diagnosed with gastritis and gastric adenocarcinoma by histopathology cases in one hospital in Rwanda. Materials and methods: Cases of chronic gastritis and gastric adenocarcinoma histologically diagnosed in a tertiary hospital in Rwanda over the period of 2016-2018 were studied for the presence of H. pylori using immunohistochemistry. Diagnosis of positive cases considered immunoreactivity as well as bacterial morphology, including spiral, rod-shaped, angulated and coccoid forms. Results: Three hundred and seven cases were included in this study; chronic gastritis and gastric adenocarcinoma representing 39% and 61%, respectively. The overall frequency of H. pylori infection was 77.5% (80% among chronic gastritis cases versus 76% among gastric adenocarcinoma cases). Prevalence of H. pylori infection in chronic gastritis and adenocarcinoma did not significantly associate with age and sex. Conclusion: The prevalence of H. pylori was high among chronic gastritis and gastric adenocarcinoma cases in Rwanda. Pathologists should investigate the presence of H. pylori in gastric biopsies. Our data shows immunohistochemistry method is feasible and adequate to facilitate detection of H. pylori, which may guide timely treatment.
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Affiliation(s)
- Theoneste Nizeyimana
- Department of Clinical Biology, School of Medicine and Pharmacy, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
| | - Belson Rugwizangoga
- Department of Clinical Biology, School of Medicine and Pharmacy, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda.,Department of Pathology at University Teaching Hospital of Kigali, Kigali, Rwanda
| | - Felix Manirakiza
- Department of Clinical Biology, School of Medicine and Pharmacy, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda.,Department of Pathology at University Teaching Hospital of Kigali, Kigali, Rwanda
| | - Alvaro C Laga
- Department of Clinical Biology, School of Medicine and Pharmacy, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda.,Department of Pathology, Brigham and Women's Hospital, Boston, Massachusetts, United States of America
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Ntirenganya F, Twagirumukiza J, Bucyibaruta G, Rugwizangoga B, Rulisa S. Breast cancer heterogeneity: Comparing pre- and postmenopausal breast cancer in an African population. J Clin Sci 2022. [DOI: 10.4103/jcls.jcls_47_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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14
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Subedi N, Bhattarai S, Mremi A, Ntakirutimana G, Ndayisaba MC, Rugwizangoga B, Mbarushimana D, Hategekimana E, Tuyizere V, Paganelli C. Building Capacity and Infrastructure at Hospitals Implementing Minimally Invasive Tissue Sampling: Experience and Lessons Learned From Nepal, Rwanda, and Tanzania. Clin Infect Dis 2021; 73:S396-S400. [PMID: 34910170 PMCID: PMC8672746 DOI: 10.1093/cid/ciab780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Minimally invasive tissue sampling (MITS) is a useful tool to determine cause of death in low- and middle-income countries (LMICs). In 2019 the MITS Surveillance Alliance supported the implementation of small-scale postmortem studies using MITS in several LMICs. METHODS In this article we describe the preparations, challenges, and lessons learned as part of implementing MITS across 4 study sites in 3 countries: Nepal, Rwanda, and Tanzania. We describe the process for building capacity to conduct MITS, which consisted of training in MITS sample collection, individual site assessment to determine readiness and gaps prior to implementation, site visits as sites began implementation of MITS, and feedback based on remote evaluation of histology slides via an online portal. RESULTS The 4 study sites each conducted 100 MITS, for a total of 400. All 4 sites lacked sufficient infrastructure and facilities to conduct MITS, and upgrades were required. Common challenges faced by sites included that clinical autopsies were neither routinely conducted nor widely accepted. Limited clinical records made cause of death determination more difficult. Lessons learned included the importance of sensitization of the community and medical staff to MITS to enhance understanding and increase consent. CONCLUSIONS The study sites accomplished MITS and utilized the available support systems to overcome the challenges. The quality of the procedures was satisfactory and was facilitated through the organized capacity-building programs.
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Affiliation(s)
- Nuwadatta Subedi
- Gandaki Medical College Teaching Hospital and Research Center, Gandaki Province, Pokhara, Nepal
| | - Suraj Bhattarai
- Gandaki Medical College Teaching Hospital and Research Center, Gandaki Province, Pokhara, Nepal
- Global Institute for Interdisciplinary Studies, Kathmandu, Nepal
| | - Alex Mremi
- Department of Pathology, Kilimanjaro Christian Medical Centre and Kilimanjaro Christian Medical University College, Moshi, Tanzania
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Rugwizangoga B, Niyibizi JB, Ndayisaba MC, Musoni E, Manirakiza F, Uwineza A, Tuyisenge L, Nyundo M, Hategekimana T, Ntakirutimana G. Exploring Perceptions and Acceptance of Minimally Invasive Tissue Sampling among Bereaved Relatives and Health-Care Professionals in Rwanda. J Multidiscip Healthc 2021; 14:3421-3427. [PMID: 34938081 PMCID: PMC8685444 DOI: 10.2147/jmdh.s340428] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Accepted: 11/25/2021] [Indexed: 11/23/2022] Open
Abstract
Purpose In most low- and lower middle-income countries (LMICs), minimally invasive tissue sampling (MITS) is a relatively new procedure for identifying the cause of death (CoD). This study aimed to explore perceptions and acceptance of bereaved families and health-care professionals regarding MITS in the context of MITS initiation in Rwanda as an alternative to clinical autopsy. Methods This was a qualitative phenomenological study with thematic analysis. Participants were bereaved relatives (individual interviews) and health-care professionals (focus-group discussions) involved in MITS implementation. It was conducted in the largest referral and teaching hospital in Rwanda. Results Motivators of MITS acceptance included eagerness to know the CoD, noninvasiveness of MITS, trust in medics, and the fact that it was free. Barriers to consent to MITS included inadequate explanations from health-care professionals, high socioeconomic status, lack of power to make decisions, and lack of trust in medics. Health-care professionals perceived both conventional autopsy and MITS as gold-standard procedures in CoD determination. They recommended including MITS among hospital services and commended the post-MITS multidisciplinary discussion panel in CoD determination. They pointed out that there might be reticence in approaching bereaved relatives to obtain consent for MITS. Both groups of participants highlighted the issue of delay in releasing MITS results. Conclusion Both health-care professionals and bereaved relatives appreciate that MITS is an acceptable procedure to include in routine hospital services. Dealing with barriers met by either group is to be considered in the eventual next phases of MITS implementation in Rwanda and similar sociocultural contexts.
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Affiliation(s)
- Belson Rugwizangoga
- Department of Clinical Biology, University of Rwanda, Kigali, Rwanda
- Department of Pathology, University Teaching Hospital of Kigali, Kigali, Rwanda
- Correspondence: Belson Rugwizangoga PO Box 655, Kigali, Rwanda, Tel +250-78-854-6597 Email ;
| | | | | | - Emile Musoni
- Department of Clinical Biology, University of Rwanda, Kigali, Rwanda
- Department of Pathology, University Teaching Hospital of Kigali, Kigali, Rwanda
| | - Felix Manirakiza
- Department of Clinical Biology, University of Rwanda, Kigali, Rwanda
- Department of Pathology, University Teaching Hospital of Kigali, Kigali, Rwanda
| | - Annette Uwineza
- Department of Clinical Biology, University of Rwanda, Kigali, Rwanda
- Department of Pathology, University Teaching Hospital of Kigali, Kigali, Rwanda
| | - Lisine Tuyisenge
- Department of Pediatrics, University Teaching Hospital of Kigali, Kigali, Rwanda
| | - Martin Nyundo
- Department of Surgery, University Teaching Hospital of Kigali, Kigali, Rwanda
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16
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Mugabe M, Ho KE, Ruhangaza D, Milner D, Rugwizangoga B, Chu VC, Wu NC, Rizo A, Weidler JM, Wong W, Bates M, Brock JE. Use of the Xpert Breast Cancer STRAT4 for Biomarker Evaluation in Tissue Processed in a Developing Country. Am J Clin Pathol 2021; 156:766-776. [PMID: 34050358 PMCID: PMC8512210 DOI: 10.1093/ajcp/aqab016] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Objectives Breast cancer immunohistochemistry (IHC) biomarker testing is limited in low-resource settings, and an alternative solution is needed. A point-of-care mRNA STRAT4 breast cancer assay for ESR1, PGR, ERBB2, and MKi67, for use on the GeneXpert platform, has been recently validated on tissues from internationally accredited laboratories, showing excellent concordance with IHC. Methods We evaluated STRAT4/IHC ESR1/estrogen receptor (ER), ERBB2/human epidermal growth factor receptor 2 (HER2) concordance rates of 150 breast cancer tissues processed in Rwanda, with undocumented cold ischemic and fixation time. Results Assay fail/indeterminate rate was 2.6% for ESR1 and ERBB2. STRAT4 agreement with ER IHC was 92.5% to 93.3% and 97.8% for HER2, for standard (1x) and concentrated (4x) reagent-conserving protocols, respectively. Eleven of 12 discordant ER/ESR1 cases were ESR1- negative/IHC-positive. These had low expression of ER by IHC in mostly very small tumor areas tested (7/12; <25 mm2). In two of three discordant HER2 cases, the STRAT4-ERBB2 result correlated with the subsequent fluorescence in situ hybridization (FISH) result. STRAT4-ERBB2 results in 9 of 10 HER2-IHC equivocal cases were concordant with FISH. Conclusions The STRAT4 assay is an alternative for providing quality-controlled breast cancer biomarker data in laboratories unable to provide quality and/or cost-efficient IHC services.
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Affiliation(s)
| | - Kenneth E Ho
- Division of Oncology Research & Development, Cepheid, Sunnyvale, CA, USA
| | | | - Dan Milner
- American Society for Clinical Pathology, Chicago, IL, USA
| | | | - Victor C Chu
- Division of Oncology Research & Development, Cepheid, Sunnyvale, CA, USA
| | - Natalie C Wu
- Division of Oncology Research & Development, Cepheid, Sunnyvale, CA, USA
| | - Annaliza Rizo
- Division of Oncology Research & Development, Cepheid, Sunnyvale, CA, USA
| | - Jodi M Weidler
- Division of Oncology Research & Development, Cepheid, Sunnyvale, CA, USA
| | - Wendy Wong
- Division of Oncology Research & Development, Cepheid, Sunnyvale, CA, USA
| | - Michael Bates
- Division of Oncology Research & Development, Cepheid, Sunnyvale, CA, USA
| | - Jane E Brock
- Department of Pathology, Brigham and Women’s Hospital, Boston, MA, USA
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17
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Rubagumya F, Costas-Chavarri A, Manirakiza A, Murenzi G, Uwinkindi F, Ntizimira C, Rukundo I, Mugenzi P, Rugwizangoga B, Shyirambere C, Urusaro S, Pace L, Buswell L, Ntirenganya F, Rudakemwa E, Fadelu T, Mpunga T, Shulman LN, Booth CM. State of Cancer Control in Rwanda: Past, Present, and Future Opportunities. JCO Glob Oncol 2021; 6:1171-1177. [PMID: 32701365 PMCID: PMC7392739 DOI: 10.1200/go.20.00281] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Rwanda is a densely populated low-income country in East Africa. Previously considered a failed state after the genocide against the Tutsi in 1994, Rwanda has seen remarkable growth over the past 2 decades. Health care in Rwanda is predominantly delivered through public hospitals and is emerging in the private sector. More than 80% of patients are covered by community-based health insurance (Mutuelle de Santé). The cancer unit at the Rwanda Biomedical Center (a branch of the Ministry of Health) is responsible for setting and implementing cancer care policy. Rwanda has made progress with human papillomavirus (HPV) and hepatitis B vaccination. Recently, the cancer unit at the Rwanda Biomedical Center launched the country’s 5-year National Cancer Control Plan. Over the past decade, patients with cancer have been able to receive chemotherapy at Butaro Cancer Center, and recently, the Rwanda Cancer Center was launched with 2 linear accelerator radiotherapy machines, which greatly reduced the number of referrals for treatment abroad. Palliative care services are increasing in Rwanda. A cancer registry has now been strengthened, and more clinicians are becoming active in cancer research. Despite these advances, there is still substantial work to be done and there are many outstanding challenges, including the need to build capacity in cancer awareness among the general population (and shift toward earlier diagnosis), cancer care workforce (more in-country training programs are needed), and research.
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Affiliation(s)
- Fidel Rubagumya
- Department of Oncology, Rwanda Military Hospital, Kigali, Rwanda.,University of Global Health Equity, Burera, Rwanda
| | | | | | - Gad Murenzi
- Department of Research, Rwanda Military Hospital, Kigali, Rwanda
| | | | | | - Ivan Rukundo
- Department of Radiology, Rwanda Military Hospital, Kigali, Rwanda
| | | | - Belson Rugwizangoga
- Department of Pathology, Kigali University Teaching Hospital, Kigali, Rwanda
| | | | - Sandra Urusaro
- Department of Oncology, Inshuti Mu Buzima, Kigali, Rwanda
| | - Lydia Pace
- Division of Women's Health, Brigham and Women's Hospital, Boston, MA
| | - Lori Buswell
- Department of Oncology, Dana-Farber Cancer Institute, Boston, MA
| | | | | | - Temidayo Fadelu
- Department of Oncology, Dana-Farber Cancer Institute, Boston, MA
| | | | - Lawrence N Shulman
- Center for Global Cancer Medicine, University of Pennsylvania, Philadelphia, PA
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18
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Mpunga T, Chantal Umulisa M, Tenet V, Rugwizangoga B, Milner Jr DA, Munyanshongore C, Heideman DA, Bleeker MC, Tommasino M, Franceschi S, Baussano I, Gheit T, Sayinzoga F, Clifford GM. Human papillomavirus genotypes in cervical and other HPV-related anogenital cancer in Rwanda, according to HIV status. Int J Cancer 2020; 146:1514-1522. [PMID: 31173641 PMCID: PMC7003740 DOI: 10.1002/ijc.32491] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Revised: 05/22/2019] [Accepted: 05/27/2019] [Indexed: 12/22/2022]
Abstract
The study aim was to describe human papillomavirus (HPV)-attributable cancer burden in Rwanda, according to anogenital cancer site, HPV type, age and HIV status. Tissue specimens of cervical, vulvar, vaginal, penile and anal cancer diagnosed in 2012-2018 were retrieved from three cancer referral hospitals and tested for high-risk (HR) HPV DNA. Cervical cancer represented the majority of cases (598 of 738), of which 96.0% were HR-HPV positive. HPV-attributable fractions in other cancer sites varied from 53.1% in 81 penile, through 76.7% in 30 vulvar, 83.3% in 24 vaginal, up to 100% in 5 anal cases. HPV16 was the predominant HR-HPV type in cervical cancer (55.0%), followed by HPV18 (16.6%) and HPV45 (13.4%). HPV16 also predominated in other cancer sites (60-80% of HR-HPV-attributable fraction). For cervical cancer, type-specific prevalence varied significantly by histology (higher alpha-9 type prevalence in 509 squamous cell carcinoma vs. higher alpha-7 type prevalence in 80 adenocarcinoma), but not between 501 HIV-negative and 97 HIV-positive cases. With respect to types targeted, and/or cross-protected, by HPV vaccines, HPV16/18 accounted for 73%, HPV31/33/45/52/58 for an additional 22% and other HR-HPV types for 5%, of HPV-attributable cancer burden, with no significant difference by HIV status nor age. These data highlight the preventive potential of the ongoing national HPV vaccination program in Rwanda, and in sub-Saharan Africa as a whole. Importantly for this region, the impact of HIV on the distribution of causal HPV types was relatively minor, confirming type-specific relevance of HPV vaccines, irrespective of HIV status.
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Affiliation(s)
- Tharcisse Mpunga
- Butaro Cancer Centre of ExcellenceMinistry of HealthButaroRwanda
| | - Marie Chantal Umulisa
- Rwanda Biomedical CentreMinistry of Health of RwandaKigaliRwanda
- International Agency for Research on CancerLyonFrance
| | - Vanessa Tenet
- International Agency for Research on CancerLyonFrance
| | - Belson Rugwizangoga
- Department of PathologyUniversity Teaching Hospital of KigaliKigaliRwanda
- University of Rwanda School of Medicine and PharmacyKigaliRwanda
| | | | | | - Daniëlle A.M. Heideman
- Amsterdam UMC, Vrije Universiteit Amsterdam, Pathology, Cancer Center AmsterdamAmsterdamThe Netherlands
| | - Maaike C.G. Bleeker
- Amsterdam UMC, Vrije Universiteit Amsterdam, Pathology, Cancer Center AmsterdamAmsterdamThe Netherlands
| | | | | | | | - Tarik Gheit
- International Agency for Research on CancerLyonFrance
| | - Felix Sayinzoga
- Rwanda Biomedical CentreMinistry of Health of RwandaKigaliRwanda
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19
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Rugwizangoga B, Andersson ME, Kabayiza JC, Nilsson MS, Ármannsdóttir B, Aurelius J, Nilsson S, Hellstrand K, Lindh M, Martner A. IFNL4 Genotypes Predict Clearance of RNA Viruses in Rwandan Children With Upper Respiratory Tract Infections. Front Cell Infect Microbiol 2019; 9:340. [PMID: 31637221 PMCID: PMC6787560 DOI: 10.3389/fcimb.2019.00340] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Accepted: 09/20/2019] [Indexed: 12/14/2022] Open
Abstract
Polymorphisms in the interferon lambda gene locus (IFNL) such as the IFNL4 genetic variants rs12979860 and rs368234815 are predictive of resolution of hepatitis C virus infection, but information about the impact of these variants in other infections is scarce. This study aimed at determining the potential impact of IFNL4 variation for the clearance of respiratory tract pathogens in Rwandan children (≤5 years old, n = 480) seeking medical care for acute respiratory infections. Nasopharyngeal swabs were retrieved from all children at the first hospital referral and from 161 children at follow-up visits 2 weeks later. The swabs were analyzed for pathogens by real-time PCR and for host cell IFNL4 genotype at rs12979860 and rs368234815. Approximately 1/3 of the children were homozygous for the rs12979860 T allele and the rs368234815 ΔG allele, which are overrepresented in subjects of African descent. These IFNL4 variants were significantly associated with reduced clearance of RNA viruses. Our results suggest that IFNL4 genotypes that are common among subjects of African descent may determine inefficacious clearance of RNA viruses from the respiratory tract.
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Affiliation(s)
- Belson Rugwizangoga
- TIMM Laboratory, Department of Infectious Diseases, Sahlgrenska Cancer Center, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Pathology Unit, Department of Clinical Biology, School of Medicine and Pharmacy, University of Rwanda, Kigali, Rwanda
| | - Maria E Andersson
- Department of Virology, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Jean-Claude Kabayiza
- Department of Virology, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Pediatrics, School of Medicine and Pharmacy, University of Rwanda, Kigali, Rwanda
| | - Malin S Nilsson
- TIMM Laboratory, Department of Infectious Diseases, Sahlgrenska Cancer Center, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Brynja Ármannsdóttir
- Department of Virology, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Johan Aurelius
- TIMM Laboratory, Department of Infectious Diseases, Sahlgrenska Cancer Center, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Staffan Nilsson
- Department of Mathematical Sciences, Chalmers University of Technology, Gothenburg, Sweden.,Department of Laboratory Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Kristoffer Hellstrand
- TIMM Laboratory, Department of Infectious Diseases, Sahlgrenska Cancer Center, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Virology, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Magnus Lindh
- Department of Virology, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Anna Martner
- TIMM Laboratory, Department of Infectious Diseases, Sahlgrenska Cancer Center, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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20
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Izimukwiye AI, Mbarushimana D, Ndayisaba MC, Bigirimana V, Rugwizangoga B, Laga AC. Cluster of Nasal Rhinosporidiosis, Eastern Province, Rwanda. Emerg Infect Dis 2019. [DOI: 10.3201/eid2509] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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21
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Izimukwiye AI, Mbarushimana D, Ndayisaba MC, Bigirimana V, Rugwizangoga B, Laga AC. Cluster of Nasal Rhinosporidiosis, Eastern Province, Rwanda. Emerg Infect Dis 2019; 25:1727-1729. [PMID: 31441764 PMCID: PMC6711207 DOI: 10.3201/eid2509.190021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
We report 4 recent cases of nasal rhinosporidiosis in Rwanda. All patients were boys or young men living in the same district (Gatsibo District, Eastern Province), suggesting a reservoir in the area. The recent reemergence of rhinosporidiosis in Rwanda might reflect increased availability of diagnostic services rather than emerging disease.
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22
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Mukanyangezi MF, Rugwizangoga B, Manzi O, Rulisa S, Hellstrand K, Tobin G, Martner A, Bienvenu E, Giglio D. Persistence rate of cervical human papillomavirus infections and abnormal cytology in Rwanda. HIV Med 2019; 20:485-495. [PMID: 31318136 DOI: 10.1111/hiv.12782] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/13/2019] [Indexed: 12/24/2022]
Abstract
OBJECTIVES In this study, we determined the incidence and persistence of human papillomavirus (HPV) strains and of squamous intraepithelial lesions (SIL) or worse cytology in 237 HIV-positive and HIV-negative Rwandan women and whether the interleukin (IL)-28B single nucleotide polymorphism (SNP) at rs12979860 correlated with susceptibility to and persistence of HPV infection. METHODS Cervical samples were collected at baseline and after 9, 18 and 24 months for a 40-HPV DNA screening test and a ThinPrep Pap test. Genotyping of the IL-28B SNP rs12979860 was performed using real-time polymerase chain reaction (PCR). RESULTS Chronic high-risk (HR) HPV infections occurred in 56% of HIV-positive women, while no HIV-negative women developed HPV chronicity. High-grade SIL (HSIL) or cancer was diagnosed in 38% of HIV-positive women with persistent HR-HPV infections. HIV and HR-HPV positivity at baseline were factors associated with an increased risk of HPV persistence. Additionally, HR-HPV positivity at baseline was associated with an increased risk of developing HSIL or worse cytology. The unfavourable T/x genotype at rs12979860 is common among Africans, and women with this genotype were found to be more commonly infected with HPV. CONCLUSIONS HPV screening in Rwanda may help to identify women at risk of developing cervical cancer and polymorphism in IL-28B may be associated with risk of contracting HPV infection.
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Affiliation(s)
- M F Mukanyangezi
- Department of Pharmacology, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
- College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
| | - B Rugwizangoga
- College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
- Tumour Immunology (TIMM) Laboratory, Sahlgrenska Cancer Center, Department of Infectious Diseases, Institute of Biomedicine, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
- University Teaching Hospital of Kigali (CHUK), Kigali, Rwanda
| | - O Manzi
- University Teaching Hospital of Kigali (CHUK), Kigali, Rwanda
| | - S Rulisa
- College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
- University Teaching Hospital of Kigali (CHUK), Kigali, Rwanda
| | - K Hellstrand
- Tumour Immunology (TIMM) Laboratory, Sahlgrenska Cancer Center, Department of Infectious Diseases, Institute of Biomedicine, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
| | - G Tobin
- Department of Pharmacology, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
| | - A Martner
- Tumour Immunology (TIMM) Laboratory, Sahlgrenska Cancer Center, Department of Infectious Diseases, Institute of Biomedicine, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
| | - E Bienvenu
- College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
| | - D Giglio
- Department of Pharmacology, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
- Department of Oncology, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
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23
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Ngendahayo E, Nzayirambaho M, Bonane A, Gasana G, Ssebuufu R, Umurangwa F, Muhawenimana E, Nyirimodoka A, Nzeyimana I, Rugwizangoga B, Muvunyi T, Musoni E, Bwogi S, Hategekimana T, Kalengayi R, Rwamasirabo E. Pattern and clinical management of penile cancer in Rwanda. African Journal of Urology 2018. [DOI: 10.1016/j.afju.2018.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
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24
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Cancedda C, Cotton P, Shema J, Rulisa S, Riviello R, Adams LV, Farmer PE, Kagwiza JN, Kyamanywa P, Mukamana D, Mumena C, Tumusiime DK, Mukashyaka L, Ndenga E, Twagirumugabe T, Mukara KB, Dusabejambo V, Walker TD, Nkusi E, Bazzett-Matabele L, Butera A, Rugwizangoga B, Kabayiza JC, Kanyandekwe S, Kalisa L, Ntirenganya F, Dixson J, Rogo T, McCall N, Corden M, Wong R, Mukeshimana M, Gatarayiha A, Ntagungira EK, Yaman A, Musabeyezu J, Sliney A, Nuthulaganti T, Kernan M, Okwi P, Rhatigan J, Barrow J, Wilson K, Levine AC, Reece R, Koster M, Moresky RT, O’Flaherty JE, Palumbo PE, Ginwalla R, Binanay CA, Thielman N, Relf M, Wright R, Hill M, Chyun D, Klar RT, McCreary LL, Hughes TL, Moen M, Meeks V, Barrows B, Durieux ME, McClain CD, Bunts A, Calland FJ, Hedt-Gauthier B, Milner D, Raviola G, Smith SE, Tuteja M, Magriples U, Rastegar A, Arnold L, Magaziner I, Binagwaho A. Health Professional Training and Capacity Strengthening Through International Academic Partnerships: The First Five Years of the Human Resources for Health Program in Rwanda. Int J Health Policy Manag 2018; 7:1024-1039. [PMID: 30624876 PMCID: PMC6326644 DOI: 10.15171/ijhpm.2018.61] [Citation(s) in RCA: 53] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2018] [Accepted: 06/19/2018] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND The Rwanda Human Resources for Health Program (HRH Program) is a 7-year (2012-2019) health professional training initiative led by the Government of Rwanda with the goals of training a large, diverse, and competent health workforce and strengthening the capacity of academic institutions in Rwanda. METHODS The data for this organizational case study was collected through official reports from the Rwanda Ministry of Health (MoH) and 22 participating US academic institutions, databases from the MoH and the College of Medicine and Health Sciences (CMHS) in Rwanda, and surveys completed by the co-authors. RESULTS In the first 5 years of the HRH Program, a consortium of US academic institutions has deployed an average of 99 visiting faculty per year to support 22 training programs, which are on track to graduate almost 4600 students by 2019. The HRH Program has also built capacity within the CMHS by promoting the recruitment of Rwandan faculty and the establishment of additional partnerships and collaborations with the US academic institutions. CONCLUSION The milestones achieved by the HRH Program have been substantial although some challenges persist. These challenges include adequately supporting the visiting faculty; pairing them with Rwandan faculty (twinning); ensuring strong communication and coordination among stakeholders; addressing mismatches in priorities between donors and implementers; the execution of a sustainability strategy; and the decision by one of the donors not to renew funding beyond March 2017. Over the next 2 academic years, it is critical for the sustainability of the 22 training programs supported by the HRH Program that the health-related Schools at the CMHS significantly scale up recruitment of new Rwandan faculty. The HRH Program can serve as a model for other training initiatives implemented in countries affected by a severe shortage of health professionals.
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Affiliation(s)
- Corrado Cancedda
- Center for Global Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Phil Cotton
- Office of the Vice-Chancellor, University of Rwanda, Kigali, Rwanda
| | - Joseph Shema
- Rwanda Human Resources for Health Program Team, Ministry of Health, Kigali, Rwanda
| | - Stephen Rulisa
- Office of the Dean, School of Medicine and Pharmacy, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
| | - Robert Riviello
- Center for Surgery and Public Health, Brigham and Women’s Hospital, Boston, MA, USA
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
| | - Lisa V. Adams
- Center for Health Equity, Geisel School of Medicine, Dartmouth College, Hanover, NH, USA
- Department of Medicine, Geisel School of Medicine, Dartmouth College, Hanover, NH, USA
| | - Paul E. Farmer
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
- Division of Global Health Equity, Department of Medicine, Brigham and Women’s Hospital, Boston, MA, USA
| | - Jeanne N. Kagwiza
- Office of the Principal, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
| | - Patrick Kyamanywa
- Department of Surgery, Faculty of Clinical Medicine and Dentistry, Kampala International University - Western Campus, Ishaka, Uganda
| | - Donatilla Mukamana
- School of Nursing and Midwifery, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
| | - Chrispinus Mumena
- Office of the Dean and Department of Oral and Maxillofacial Surgery, Oral Pathology and Oral Medicine, School of Dentistry, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
| | - David K. Tumusiime
- School of Health Sciences, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
| | - Lydie Mukashyaka
- Rwanda Human Resources for Health Program Team, Ministry of Health, Kigali, Rwanda
| | - Esperance Ndenga
- Rwanda Human Resources for Health Program Team, Ministry of Health, Kigali, Rwanda
| | - Theogene Twagirumugabe
- Department of Anesthesiology, School of Medicine and Pharmacy, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
| | - Kaitesi B. Mukara
- Department of Ear, Nose, and Throat, School of Medicine and Pharmacy, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
| | - Vincent Dusabejambo
- Department of Internal Medicine, School of Medicine and Pharmacy, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
| | - Timothy D. Walker
- Department of Internal Medicine, School of Medicine and Pharmacy, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
- School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Newcastle, NSW, Australia
- Department of General Medicine, Calvary Mater Hospital, Newcastle, NSW, Australia
| | - Emmy Nkusi
- Department of Neurosurgery, School of Medicine and Pharmacy, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
| | - Lisa Bazzett-Matabele
- Department of Obstetrics, Gynecology, and Reproductive Sciences, Yale School of Medicine, New Haven, CT, USA
| | - Alex Butera
- Department of Orthopedic Surgery, Rwanda Military Hospital, Kigali, Rwanda
| | - Belson Rugwizangoga
- Department of Pathology, School of Medicine and Pharmacy, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
| | - Jean Claude Kabayiza
- Department of Pediatrics, School of Medicine and Pharmacy, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
| | - Simon Kanyandekwe
- Department of Mental Health, School of Medicine and Pharmacy, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
| | - Louise Kalisa
- Department of Radiology, School of Medicine and Pharmacy, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
| | - Faustin Ntirenganya
- Department of Surgery, School of Medicine and Pharmacy, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
| | | | - Tanya Rogo
- Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York City, NY, USA
- Department of Pediatrics, BronxCare Health System, Bronx, NY, USA
| | - Natalie McCall
- Department of Pediatrics, Yale School of Medicine, New Haven, CT, USA
| | - Mark Corden
- Division of Hospital Medicine, Department of Pediatrics, Children’s Hospital Los Angeles, Los Angeles, CA, USA
- Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Rex Wong
- Global Health Leadership Institute, Yale School of Public Health, New Haven, CT, USA
| | - Madeleine Mukeshimana
- School of Nursing and Midwifery, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
| | - Agnes Gatarayiha
- Office of the Dean and Department of Oral and Maxillofacial Surgery, Oral Pathology and Oral Medicine, School of Dentistry, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
- Department of Preventive and Community Dentistry, School of Dentistry, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
| | - Egide Kayonga Ntagungira
- School of Health Sciences, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
| | - Attila Yaman
- Division of Global Health Equity, Department of Medicine, Brigham and Women’s Hospital, Boston, MA, USA
| | | | - Anne Sliney
- Clinton Health Access Initiative, Boston, MA, USA
| | | | | | - Peter Okwi
- Clinton Health Access Initiative, Kigali, Rwanda
| | - Joseph Rhatigan
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
- Division of Global Health Equity, Department of Medicine, Brigham and Women’s Hospital, Boston, MA, USA
| | - Jane Barrow
- Office of Global and Community Health, Harvard School of Dental Medicine, Boston, MA, USA
- Department of Oral Health Policy and Epidemiology, Harvard School of Dental Medicine, Boston, MA, USA
| | - Kim Wilson
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
- Department of General Pediatrics, Boston Children’s Hospital, Boston, MA, USA
| | - Adam C. Levine
- Department of Emergency Medicine, Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Rebecca Reece
- Department of Medicine, Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Michael Koster
- Department of Pediatrics, Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Rachel T. Moresky
- sidHARTe Program, Heilbrunn Department of Population and Family Health, Mailman School of Public Health, Columbia University, New York City, NY, USA
- Department of Emergency Medicine, Columbia University College of Physicians and Surgeons, New York City, NY, USA
| | - Jennifer E. O’Flaherty
- Department of Anesthesiology, Geisel School of Medicine, Dartmouth College, Hanover, NH, USA
- Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA
| | - Paul E. Palumbo
- Department of Medicine, Geisel School of Medicine, Dartmouth College, Hanover, NH, USA
- Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA
- Department of Pediatrics, Geisel School of Medicine, Dartmouth College, Hanover, NH, USA
| | - Rashna Ginwalla
- Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA
- Department of Surgery, Geisel School of Medicine, Dartmouth College, Hanover, NH, USA
| | | | - Nathan Thielman
- Department of Medicine, Duke University School of Medicine, Durham, NC, USA
- Duke Global Health Institute, Durham, NC, USA
- Duke University Medical Center, Durham, NC, USA
| | - Michael Relf
- Duke Global Health Institute, Durham, NC, USA
- Duke University School of Nursing, Durham, NC, USA
| | - Rodney Wright
- Department of Obstetrics & Gynecology and Women’s Health, Albert Einstein College of Medicine, New York City, NY, USA
- Obstetrics & Gynecology and Women’s Health, Montefiore Medical Center, New York City, NY, USA
| | - Mary Hill
- Division of Nursing, Howard University College of Nursing and Allied Health Sciences, Washington, DC, USA
| | - Deborah Chyun
- University of Connecticut School of Nursing, Storrs, CT, USA
| | - Robin T. Klar
- New York University Rory Meyers College of Nursing, New York City, NY, USA
| | - Linda L. McCreary
- University of Illinois at Chicago College of Nursing, Chicago, IL, USA
| | - Tonda L. Hughes
- Columbia University School of Nursing, New York City, NY, USA
| | - Marik Moen
- Department of Family & Community Health, University of Maryland School of Nursing, Baltimore, MD, USA
- Global Education and Mentorship, Office of Global Health, University of Maryland School of Nursing, Baltimore, MD, USA
| | - Valli Meeks
- Department of Oncology & Diagnostic Sciences, University of Maryland School of Dentistry, Baltimore, MD, USA
| | - Beth Barrows
- Office of Global Health, University of Maryland School of Nursing, Baltimore, MD, USA
- Partnerships, Professional Education, and Practice, University of Maryland School of Nursing, Baltimore, MD, USA
| | - Marcel E. Durieux
- Department of Anesthesiology, University of Virginia School of Medicine, Charlottesville, VA, USA
| | - Craig D. McClain
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
- Department of Anesthesiology Perioperative and Pain Medicine, Boston Children’s Hospital, Boston, MA, USA
| | - Amy Bunts
- Department of Surgery, University of Virginia School of Medicine, Charlottesville, VA, USA
| | - Forrest J. Calland
- Department of Surgery, University of Virginia School of Medicine, Charlottesville, VA, USA
| | - Bethany Hedt-Gauthier
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
| | - Danny Milner
- Center for Global Health, American Society for Clinical Pathology, Chicago, IL, USA
- Department of Immunology and Infectious Diseases, Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - Giuseppe Raviola
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
- Department of Psychiatry, Boston Children’s Hospital, Boston, MA, USA
| | - Stacy E. Smith
- Department of Radiology, Brigham and Women’s Hospital, Boston, MA, USA
| | - Meenu Tuteja
- Global Health and Research Programs, Biomedical Research Institute, Brigham and Women’s Hospital, Boston MA, USA
| | - Urania Magriples
- Department of Obstetrics, Gynecology, and Reproductive Sciences, Yale School of Medicine, New Haven, CT, USA
| | - Asghar Rastegar
- Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA
| | - Linda Arnold
- Department of Pediatrics, Yale School of Medicine, New Haven, CT, USA
| | | | - Agnes Binagwaho
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
- Department of Pediatrics, Geisel School of Medicine, Dartmouth College, Hanover, NH, USA
- Institute for Health Policy and Clinical Practice, Dartmouth College, Hanover, NH, USA
- Office of the Vice-Chancellor, University of Global Health Equity, Kigali, Rwanda
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Umulisa MC, Franceschi S, Baussano I, Tenet V, Uwimbabazi M, Rugwizangoga B, Heideman DAM, Uyterlinde AM, Darragh TM, Snijders PJF, Sayinzoga F, Clifford GM. Evaluation of human-papillomavirus testing and visual inspection for cervical cancer screening in Rwanda. BMC Womens Health 2018; 18:59. [PMID: 29699549 PMCID: PMC5921370 DOI: 10.1186/s12905-018-0549-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2017] [Accepted: 04/09/2018] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND A pilot screening campaign in Rwanda, based on careHPV-testing followed by visual inspection with acetic acid triage (careHPV+VIA triage), was evaluated against other WHO-recommended screening options, namely HPV screen-and-treat and VIA screen-and-treat. METHODS 764 women aged 30-69 underwent at visit 1: i) VIA, and cervical cell collection for ii) careHPV in Rwanda, and iii) liquid-based cytology and GP5+/6+ HR-HPV PCR in The Netherlands. All 177 women positive by VIA, careHPV and/or PCR were recalled, of whom 84% attended. At visit 2, VIA was again used to triage screen-positive women for treatment and to obtain biopsies from all women either from visible lesions or at 12 o'clock of the squamocolumnar junction. Cross-sectional screening indices were estimated primarily against histological high-grade squamous intraepithelial lesions or worse (hHSIL+), after imputation of missing histology data, based on 1-visit or 2-visit approaches. RESULTS In a 1-visit screen-and-treat approach, VIA had sensitivity and specificity of 41% and 96%, respectively, versus 71% and 88% for careHPV, and 88% and 86% for PCR. In a 2-visit approach (in which hHSIL+ imputed among women without visit 2 were considered untreated) careHPV sensitivity dropped to 59% due to loss of 13% of hHSIL+. For careHPV+VIA triage, sensitivity dropped further to 35%, as another 24% of hHSIL+ were triaged to no treatment. CONCLUSIONS CareHPV was not as sensitive as gold-standard PCR, but detected considerably more hHSIL+ than VIA. However, due to careHPV-positive hHSIL+ women being lost to follow-up and/or triaged to no treatment, 2-visit careHPV+VIA triage did not perform better than VIA screen-and-treat.
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Affiliation(s)
| | - Silvia Franceschi
- Cancer Epidemiology Unit, Aviano National Cancer Institute IRCCS, Aviano, Italy
| | - Iacopo Baussano
- International Agency for Research on Cancer, 150 cours Albert Thomas, 69372 Lyon Cedex 08, France
| | - Vanessa Tenet
- International Agency for Research on Cancer, 150 cours Albert Thomas, 69372 Lyon Cedex 08, France
| | | | - Belson Rugwizangoga
- Department of Pathology, University Teaching Hospital of Kigali, Kigali, Rwanda
- University of Rwanda School of Medicine and Pharmacy, Kigali, Rwanda
| | | | - Anne M. Uyterlinde
- Department of Pathology, VU University Medical Center, Amsterdam, the Netherlands
| | | | - Peter J. F. Snijders
- Department of Pathology, VU University Medical Center, Amsterdam, the Netherlands
| | | | - Gary M. Clifford
- International Agency for Research on Cancer, 150 cours Albert Thomas, 69372 Lyon Cedex 08, France
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Nelson AM, Hale M, Diomande MIJM, Eichbaum Q, Iliyasu Y, Kalengayi RM, Rugwizangoga B, Sayed S. Training the Next Generation of African Pathologists. Clin Lab Med 2018; 38:37-51. [DOI: 10.1016/j.cll.2017.10.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Chamberlin MD, Rugwizangoga B, DeAbreu FB, Rutaganda E, Dusabejambo V, Habyarimana O, Bensen S, Tsongalis GJ. Feasibility Study of Molecular Profiling of Gastric Cancer Specimens From Rwanda. J Glob Oncol 2017. [DOI: 10.1200/jgo.2017.009605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Abstract 51 Background: Gastric cancer is associated with high mortality in Rwanda. Geographic or genetic differences may lead to variations in somatic mutations and novel therapies. Overseas collaboration to determine gastric cancer molecular profiles is paramount. We undertook this work to determine the feasibility of collaboration between researchers in Rwanda and the United States by creating a research platform for gastric and other cancers in Rwanda. Methods: Patients consented for biopsy. Cases that were confirmed as gastric adenocarcinoma were included. Formalin-fixed paraffin-embedded tissue blocks or eight unstained sections (4 μm) were transported to the United States. DNA extraction and library preparation was performed by using 50 ng gDNA. Samples were normalized, pooled, and sequenced by using the Pillar NGS SLIMamp Lung Hot Spot Panel (Pillar Biosciences, Natick, MA). FASTq files were uploaded to Pillar Biosciences to perform sequence alignment, annotation, and variant classification. Results: Fifty-seven samples were received and 35 were excluded because of low DNA yield or quality (18 and 17, respectively). Mutations were detected in nine (41%) of 22 samples. One sample contained three mutations, other cases had one to two mutations identified. In total, 12 mutations were identified: TP53 (four), SMAD4 (two), ERBB4 (two; S341L and D228N), PTEN (two; K267RfsTer9 and C136Y), FBXW7 (one), and KRAS (one). Conclusion: Overseas collaboration for the molecular profiling of gastric cancer samples is feasible. Quality improved with larger biopsies or tissue blocks. Frequency of mutations is lower than expected. ERBB4 mutations identified are not known to be pathogenic. PTEN mutations are considered pathogenic—a potential target for therapy in larger trials. A larger fusion panel may be more effective in identifying potential targets. Funding: Pillar Biosciences provided reagents for sequencing. AUTHORS' DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST Mary D. Chamberlin Research Funding: Pillar Biosciences Belson Rugwizangoga No relationship to disclose Francine B. DeAbreu No relationship to disclose Eric Rutaganda No relationship to disclose Vincent Dusabejambo No relationship to disclose Oswald Habyarimana No relationship to disclose Steve Bensen No relationship to disclose Gregory J. Tsongalis Honoraria: Roche, ChromaCode, Foundation Medicine, Physician Choice Labs Consulting or Advisory Role: Baystate Health System, Jackson Laboratory for Genomic Medicine (Inst) Research Funding: Qiagen, Illumina, QuanDx, Leica Biosystems, Abbott Molecular, Affymetrix
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Affiliation(s)
- Mary D. Chamberlin
- Mary D. Chamberlin, Francine B. DeAbreu, Steve Bensen, and Gregory J. Tsongalis, Dartmouth-Hitchcock Medical Center, and Geisel School of Medicine at Dartmouth, Lebanon, NH; and Belson Rugwizangoga, Eric Rutaganda, Vincent Dusabejambo, and Oswald Habyarimana, University of Rwanda College of Medicine and Health Sciences, Kigali, Rwanda
| | - Belson Rugwizangoga
- Mary D. Chamberlin, Francine B. DeAbreu, Steve Bensen, and Gregory J. Tsongalis, Dartmouth-Hitchcock Medical Center, and Geisel School of Medicine at Dartmouth, Lebanon, NH; and Belson Rugwizangoga, Eric Rutaganda, Vincent Dusabejambo, and Oswald Habyarimana, University of Rwanda College of Medicine and Health Sciences, Kigali, Rwanda
| | - Francine B. DeAbreu
- Mary D. Chamberlin, Francine B. DeAbreu, Steve Bensen, and Gregory J. Tsongalis, Dartmouth-Hitchcock Medical Center, and Geisel School of Medicine at Dartmouth, Lebanon, NH; and Belson Rugwizangoga, Eric Rutaganda, Vincent Dusabejambo, and Oswald Habyarimana, University of Rwanda College of Medicine and Health Sciences, Kigali, Rwanda
| | - Eric Rutaganda
- Mary D. Chamberlin, Francine B. DeAbreu, Steve Bensen, and Gregory J. Tsongalis, Dartmouth-Hitchcock Medical Center, and Geisel School of Medicine at Dartmouth, Lebanon, NH; and Belson Rugwizangoga, Eric Rutaganda, Vincent Dusabejambo, and Oswald Habyarimana, University of Rwanda College of Medicine and Health Sciences, Kigali, Rwanda
| | - Vincent Dusabejambo
- Mary D. Chamberlin, Francine B. DeAbreu, Steve Bensen, and Gregory J. Tsongalis, Dartmouth-Hitchcock Medical Center, and Geisel School of Medicine at Dartmouth, Lebanon, NH; and Belson Rugwizangoga, Eric Rutaganda, Vincent Dusabejambo, and Oswald Habyarimana, University of Rwanda College of Medicine and Health Sciences, Kigali, Rwanda
| | - Oswald Habyarimana
- Mary D. Chamberlin, Francine B. DeAbreu, Steve Bensen, and Gregory J. Tsongalis, Dartmouth-Hitchcock Medical Center, and Geisel School of Medicine at Dartmouth, Lebanon, NH; and Belson Rugwizangoga, Eric Rutaganda, Vincent Dusabejambo, and Oswald Habyarimana, University of Rwanda College of Medicine and Health Sciences, Kigali, Rwanda
| | - Steve Bensen
- Mary D. Chamberlin, Francine B. DeAbreu, Steve Bensen, and Gregory J. Tsongalis, Dartmouth-Hitchcock Medical Center, and Geisel School of Medicine at Dartmouth, Lebanon, NH; and Belson Rugwizangoga, Eric Rutaganda, Vincent Dusabejambo, and Oswald Habyarimana, University of Rwanda College of Medicine and Health Sciences, Kigali, Rwanda
| | - Gregory J. Tsongalis
- Mary D. Chamberlin, Francine B. DeAbreu, Steve Bensen, and Gregory J. Tsongalis, Dartmouth-Hitchcock Medical Center, and Geisel School of Medicine at Dartmouth, Lebanon, NH; and Belson Rugwizangoga, Eric Rutaganda, Vincent Dusabejambo, and Oswald Habyarimana, University of Rwanda College of Medicine and Health Sciences, Kigali, Rwanda
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Brock J, Mugabe M, Andrici J, Rugwizangoga B, Milner D. A single FFPE lysate preparation method for use with the Xpert Breast Cancer STRAT4 provides a streamlined solution for testing in developing countries. Breast 2017. [DOI: 10.1016/s0960-9776(17)30124-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Abstract
BACKGROUND Coats' disease is an exudative retinal detachment with vascular telangiectasis occurring mostly in male children, the age group most affected by retinoblastoma. OBJECTIVES Compare the differential diagnoses of Coats' disease Establish recommendation to early disease detection. MATERIALS AND METHODS A 3-year-old female child was referred to Muhimbili National Hospital (MNH), Tanzania, in September 2011. She had presented at the peripheral hospital with gradual onset of left eye leukocoria for 1 year and pain for 2 months. B-scan showed a mass in the left eye. A clinical diagnosis of retinoblastoma was made. Left eye enucleation was performed; the patient was referred to MNH, with the enucleated specimen. RESULTS Brain and orbits scan revealed no residual tumour. The globe measured 2 x 1.8 cm, the optic nerve stump measured 3 mm. A whitish mass filled the vitreous, with complete retinal detachment. Microscopy showed retinal gliosis, detachment with sub retinal PAS positive exudates, vacuolation and cholesterol clefts. Foreign body giant cells were present; telangiectatic thin-walled blood vessels were identified. Clinico-pathological findings were of stage 4 Coats' disease. CONCLUSION Coats' disease is an important differential diagnosis of retinoblastoma. Delay to detect Coats' disease leads to vision loss which necessitates eye enucleation as was in this child.
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Mwita JC, Chipeta P, Mutagaywa R, Rugwizangoga B, Ussiri E. Pericardial cyst with right ventricular compression. Pan Afr Med J 2012; 12:60. [PMID: 22937200 PMCID: PMC3428180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2012] [Accepted: 06/25/2012] [Indexed: 11/21/2022] Open
Abstract
Pericardial cysts are infrequent and benign mediastinal lesions. While most pericardial cysts are asymptomatic, some patients may present with compression symptoms. We present the case of a 22-year-old man who presented with a right pericardial cyst that caused compression of the right ventricle.
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Affiliation(s)
- Julius Chacha Mwita
- Muhimbili University of Health and Allied Sciences, Tanzania,Corresponding author: Julius Chacha Mwita, Department of Internal medicine, Muhimbili University of Health Sciences, Tanzania
| | - Peter Chipeta
- Muhimbili University of Health and Allied Sciences, Tanzania
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