Friday, June 2, 2017

Sustainable Development of Pathology in Sub-Saharan Africa: An Example From Ghana

Helge StalsbergMD, PhDErnest Kwasi AdjeiMD, FRCPOsei Owusu-AfriyieMDVidar IsaksenMD

From the Department of Pathology, University of Tromsø (Dr Stalsberg), and the Department of Pathology, University Hospital of North Norway (Drs Stalsberg and Isaksen), Tromsø, Norway; and the Department of Pathology, Komfo Anokye Teaching Hospital, Kumasi, Ghana (Drs Adjei and Owusu-Afriyie).
Reprints: Helge Stalsberg, MD, PhD, Department of Pathology, University Hospital of North Norway, 9038 Tromsø, Norway (email: ).
Context.— Pathology services are poorly developed in Sub-Saharan Africa. Komfo Anokye Teaching Hospital in Kumasi, Ghana, asked for help from the pathology department of the University Hospital of North Norway, Tromsø.
Objective.— To reestablish surgical pathology and cytology in an African pathology department in which these functions had ceased completely, and to develop the department into a self-supporting unit of good international standard and with the capacity to train new pathologists.
Design.— Medical technologists from Kumasi were trained in histotechnology in Norway, they were returned to Kumasi, and they produced histologic slides that were temporarily sent to Norway for diagnosis. Two Ghanaian doctors were trained in pathology for 4 years in Norway. Mutual visits by pathologists and technologists from the 2 hospitals were arranged for the introduction of immunohistochemistry and cytology. Pathologists from Norway visited Kumasi for 1 month each year during 2007–2010. Good microscopes and immunohistochemistry equipment were provided from Norway. Other laboratory equipment and a new building were provided by the Ghanaian hospital.
Results.— The Ghanaian hospital had a surgical pathology service from the first project year. At 11 years after the start of the project, the services included autopsy, surgical pathology, cytopathology, frozen sections, and limited use of immunohistochemistry, and the department had 10 residents at different levels of training.
Conclusions.— A Ghanaian pathology department that performed autopsies only was developed into a self-supported department with surgical pathology, cytology, immunohistochemistry, and frozen section service, with an active residency program and the capacity for further development that is independent from assistance abroad.

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