Understanding the bricks to build better surgical oncology unit at Maputo Central Hospital: prevalent surgical cancers and residents knowledge

  • Atílio Morais Surgical Department, Maputo Central Hospital, Maputo, Mozambique; Department of Surgery of Faculty of Medicine, University of Eduardo Mondlane, Maputo, Mozambique
  • Jotamo Come Surgical Department, Maputo Central Hospital, Maputo, Mozambique
  • Carlos Selemane Surgical Department, Maputo Central Hospital, Maputo, Mozambique
  • Germano Pires Surgical Department, Maputo Central Hospital, Maputo, Mozambique
  • Adriano Tivane Surgical Department, Maputo Central Hospital, Maputo, Mozambique
  • Matchecane Cossa Surgical Department, Maputo Central Hospital, Maputo, Mozambique
  • Satish Tulsidás Medical Oncology Department, Maputo Central Hospital, Maputo, Mozambique
  • Luís Antunes Epidemiology Service, Portuguese Institute of Oncology, Porto, Portugal
  • Manuel João Costa Medical Education Unit, School of Medicine University of Minho, Portugal
  • Moshin Sidat Department of Community Health, University of Eduardo Mondlane, Maputo, Mozambique; Global Health and Tropical Medicine, Institute of Hygiene and Tropical Medicine, NOVA University of Lisbon, Portugal
  • Maria do Rosário Martins Global Health and Tropical Medicine, Institute of Hygiene and Tropical Medicine, NOVA University of Lisbon, Portugal
  • Carla Carrilho Pathology Department, Maputo Central Hospital, Maputo, Mozambique
  • Lúcio Lara Santos Surgical Oncology Department, Portuguese Institute of Oncology, Porto, Portugal; Experimental Pathology and Therapeutics Research Group, Portuguese Institute of Oncology, Porto, Portugal; ONCOCIR- Education and Care in Oncology, Lusophone, Africa
Keywords: Cancer surgery; Resident knowledge; Mozambique

Abstract

Introduction: cancer is a growing concern in Mozambique. However, the country has limited facilities and few oncologists. Surgical oncologists are an unmet need. The aim of this study was to assess residents' knowledge in prevalent cancer domains and to identify and characterize prevalent cancers treated by surgery at Maputo Central Hospital, the largest hospital in Mozambique. The expectations were that the findings shall inform the development of a comprehensive curriculum in surgical oncology fellowship fit for the Hospital.

Methods: to identify and characterize prevalent cancers, we performed a retrospective analysis of individual cancer patient registries of Maputo Central Hospital (MCH), Mozambique. Information was recorded into data collection sheets and analyzed with SPSS® 21. To assess MCH residents oncologic knowledge, we invited Twenty-six junior residents (49% of all residents) of different specialties to take a 30 item multiple choice written test used elsewhere in previous studies. The test focused on the domains of Basis of oncology, Radiotherapy, Pathology, Chemotherapy, Pain management, Surgical oncology and Clinical Pathway. The test was administered anonymously and without prior notice. We analyzed the overall test and topic performance of residents.

Results: the study covered a period of 3 years and 203 patients. The most prevalent malignant tumors treated by general and thoracic surgery in MCH cancer registry were esophageal (7%), female breast (6.5%) and colorectal cancer (2.8%). Globally these malignancies were diagnosed at an advanced stage of the disease and required a multimodal treatment. The mean percent correct score of residents was 37.3%. The dimension with the highest percent correct score were clinical management (46%) and surgical oncology (28%) showed the lowest correct score.

Conclusion: in Maputo, Mozambique esophageal, breast and colorectal cancer were the most prevalent malignancies treated, with surgery, by thoracic or general surgery in MCH. The test scores suggest that, among residents, the knowledge in oncology needs to be improved, rendering support to the need of a surgical oncology training tailored to suit the local needs. Specific training should take into account local cancer prevalence, resources, their quality and the support of surgical oncology services with volume and experience.

Published
2019-02-18
Section
Articles

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eISSN: 1937-8688