Task Shifting and Skin Punch for the Histologic Diagnosis of Kaposi's Sarcoma in Sub-Saharan Africa: A Public Health Solution to a Public Health Problem

Oncology
Miriam O Laker-OkettaJeffrey Martin

Abstract

Fueled by HIV, sub-Saharan Africa has the highest incidence of Kaposi's sarcoma (KS) in the world. Despite this, KS diagnosis in the region is based mostly on clinical grounds. Where biopsy is available, it has traditionally been excisional and performed by surgeons, resulting in multiple appointments, follow-up visits for suture removal, and substantial costs. We hypothesized that a simpler approach - skin punch biopsy - would make histologic diagnosis more accessible. To address this, we provided training and equipment for skin punch biopsy of suspected KS to three HIV clinics in East Africa. The procedure consisted of local anesthesia followed by a disposable cylindrical punch blade to obtain specimens. Hemostasis is facilitated by Gelfoam®. Patients removed the dressing after 4 days. From 2007 to 2013, 2,799 biopsies were performed. Although originally targeted to be used by physicians, biopsies were performed predominantly by nurses (62%), followed by physicians (15%), clinical officers (12%) and technicians (11%). There were no reports of recurrent bleeding or infection. After minimal training and provision of inexpensive equipment (USD 3.06 per biopsy), HIV clinics in East Africa can integrate same-day skin punch biopsy ...Continue Reading

Citations

Nov 19, 2015·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Fredrick Chite AsirwaPatrick J Loehrer
Jul 22, 2017·The British Journal of Dermatology·A Y ChangT A Maurer
Dec 12, 2017·Current Dermatology Reports·Divya SethEsther F Freeman
Oct 10, 2015·Journal of Acquired Immune Deficiency Syndromes : JAIDS·Erin AmersonJeffrey Martin
Feb 2, 2019·Nature Reviews. Disease Primers·Ethel CesarmanDenise Whitby
Jul 19, 2020·Human Resources for Health·Phylisha van HeemskerkenLeon Bijlmakers
Mar 20, 2021·JCO Global Oncology·Mercy A OduorFredrick C Asirwa
Apr 18, 2021·The Journal of Investigative Dermatology·Devon E McMahonUNKNOWN International Epidemiology Databases to Evaluate AIDS (IeDEA)
May 5, 2021·Indian Journal of Dermatology, Venereology and Leprology· KavitaSunil Dogra
Aug 9, 2020·Journal of the American Academy of Dermatology·Divya SethUNKNOWN International Epidemiology Databases to Evaluate AIDS (IeDEA)

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