By Mark Mudenyo - Principal Investigator Ms Mercy Mugo - Co - - PowerPoint PPT Presentation

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Dec 05, 2022 11 likes •203 views

By Mark Mudenyo - Principal Investigator Ms Mercy Mugo - Co Investigator KNH HBCR The hospital attends to an average of 550,000 out- patients and over 80,000 in-patients annually Currently between 2,000-2,500 new patients are seen per

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By Mark Mudenyo - Principal Investigator Ms Mercy Mugo - Co Investigator

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KNH HBCR

 The hospital attends to an average of 550,000 out-

patients and over 80,000 in-patients annually

 Currently between 2,000-2,500 new patients are seen

per year.

 130 - 150 patients receives radiotherapy daily

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KNH –Hospital based cancer registry

 The registry was started by group of professionals with

skills in operational research, cancer care, training and curriculum development, information and technology, resource mobilization and public health.

 The group aims to Offer technical support to MoH in

cancer care and control.

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Broad Objective

 The main objective was to establish a quality KNH

Hospital Based Cancer Registry in order to comply with the National Cancer Prevention and Control Strategy and provide quality cancer data for improved care, teaching and research.

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Specific objectives

 To establish a HBCR at the KNH by capturing, and

integrating existing cancer information from all departments within the hospital

 To estimate cancer trends at KNH  To create a quality system and database for continuing

cancer data documentation at KNH

 To link with the National Cancer registry and avail

data for research in Kenya

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Methodology

 The KNH cancer registry is based in the Health

Information Department and managed by KNH staff together with the University of Nairobi and other affiliated institutions.

 KNH registry work in collaboration with National

Cancer Registry at KEMRI, in data collection analysis and report writing.

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Methodology cont…

 Cancer data is collected by trained registrars using the

standard CANREG5(1) data entry software system.

 Cancer diagnosis is based on histology/cytology,

imaging and clinical guidelines.

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Source of data

Records of all patients diagnosed with cancer are

abstracted and documented including co-morbidities

Sources of data: patient files, laboratory reports,

autopsy records, radio-oncology, palliative care centre, Nairobi Hospice, Cancer Care Centre, KNH CCC, University of Nairobi Clinical departments and Pediatrics Oncology unit among others.

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AGE DISTRIBUTION OF CANCER CASES

Age group Males % Females % Total 0-14 411 10 293 5 704 15-29 329 8 390 6 719 30-49 954 24 2503 40 3457 50-69 1621 40 2368 38 3989 70+ 741 18 725 12 1466 Total 4056 100 6279 100 10335

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TOP 10 FEMALE CANCER CASE

200 400 600 800 1000 1200 1400 1600 1800 2000 No of cases

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TOP 10 MALE CANCER CASES

50 100 150 200 250 300 350 400 450 500 No of cases

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CHILDHOOD CANCER

ICCC-Classification AGE GROUP 0-4 5-9 10-14 ALL Leukemia, Myelopro/Myelodys.dis. 41 59 57 157 Lymphomas, Reticuloendothelial 14 47 36 97 CNS, Intracranial/Spinal 12 31 16 59 Neuroblastoma, Per.nerv.cell 3 3 6 Retinoblastoma 119 6 125 Wilms Tumor 75 26 2 103 Hepatic Tumor 5 1 1 7 Malignant bone Tumor 2 7 15 24 Soft tissue, Extraoss.Sarcoma 19 10 9 38 Germ cell, Trophoblast,Gonad 3 4 5 12 Malig.Epithelial/Melanoma 2 7 23 32 TOTAL 295 201 164 660

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CANCER CASES PER COUNTY SEEN AT KNH

COUNTY FREQUENCY PERCENTAGE NAIROBI 2272 22 KIAMBU 1183 11 MURANGA 838 8 MERU 601 6 MACHAKOS 591 6 NYERI 579 6 KIRINYAGA 424 4 NAKURU 369 4 KITUI 331 3 MAKUENI 304 3

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HIV AND CANCER CASES

Age group Males HIV Positive Females HIV Positive 0-14 411 14 293 4 15-29 329 13 390 42 30-49 954 134 2503 435 50-69 1621 69 2368 202 70+ 741 8 725 4 Total 4056 238 6279 687

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Year DiseaseCod e

LEADING CAUSES OF HOSPITALIZATION 2015

ALIVE DEAD

2015C*

CANCERS 4241 1315

2015J18.9

Pneumonia, 1950 491

2015P36.9

Bacterial sepsis of newborn, 1910 764

2015B24

Human immunodeficiency virus [HIV] Complications 1723 733

2015A09

DIARRHOEA 1103 252

2015S09.9

injury of head 922 254

2015P59.9

Neonatal jaundice, 891 204

2015I10

Essential (primary) hypertension 835 271

2015P07.3

Other preterm infants 644 736

2015G03.9

Meningitis, 628 250

2015E14.9

Diabetes 522 200

2015J35.3

Hypertrophy of tonsils with hypertrophy of adenoids 493 4

Year Disease Code

LEADING CAUSES OF HOSPITALIZATION 2016

ALIVE DEAD

2016C*

CANCERS 4325 1111

2016B24

Human immunodeficiency virus [HIV] Complications 1638 609

2016J18.9

Pneumonia, 1479 432

2016P36.9 Bacterial sepsis of newborn,

1392 567

2016S09.9

injury of head 1033 240

2016I10

Essential (primary) hypertension 944 236

2016A09

DIARRHOEA 720 175

2016P59.9 Neonatal jaundice,

671 151

2016P07.3 Other preterm infants

655 670

2016G03.9 Meningitis,

554 249 Cancer was the leading cause of hospitalization in both 2015 and 2016 . In 2016 this represents a 6% of the total diseases reported in the period while 2015, it constitutes a 5% of the total diseases reported in the hospital.

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Year CODE LEADING CAUSES OF DEATHS 2016 DEAD PMR %

2016C* CANCERS 1111 14 2016P07.3 Other preterm infants 670 8.3 2016B24 Human immunodeficiency virus [HIV] Complications 609 7.6 2016P36.9 Bacterial sepsis of newborn, 567 7.0 2016P22.0 Respiratory distress syndrome of newborn 472 5.9 2016J18.9 Pneumonia, 432 5.4 2016P07.1 Other low birth weight 417 5.2 2016N17.9 Acute renal failure, 339 4.2 2016A41.9 Sepsis, 329 4.1 2016P21.9 Birth asphyxia, 258 3.2 2016G03.9 Meningitis, 249 3.1

Year Code LEADING CAUSES OF DEATHS 2015 DEAD PMR %

2015C* CANCERS 1315 15 2015P36.9 Bacterial sepsis of newborn, 764 9.2 2015P07.3 Other preterm infants 736 8.8 2015B24 Human immunodeficiency virus [HIV] Complications 733 8.8 2015P22.0 Respiratory distress syndrome of newborn 616 7.4 2015J18.9 Pneumonia, 491 5.9 2015P07.1 Other low birth weight 470 5.6 2015N17.9 Acute renal failure, 415 5.0 2015A41.9 Sepsis, 330 4.0 2015I10 Essential (primary) hypertension 271 3.2

In 2016 the cancer deaths represent 14% proportionate deaths rate (8055) occurring in the hospital while in 2015 the deaths represent a 15% proportionate deaths rate (8346)

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Limitations

 Certified cancer registrars: KNH has only two  Data is for 2014 to 2016  No backup of data  Counties data not represented

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Recommendations:

 Intensify clinical audit for cancers cases.  Prevention of HIV to reduce HIV/Cancer related

infection.

 Increase cancer screening awareness e.g. mammogram  Increase of cancer registrars at KNH.  Proper backup of data.  Expand the registry to cover county data

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Acknowledgement

 Prof. Lucy Muchiri  Prof. C. Kigondo  Prof. P. Wainganjo  Dr. J. Rajab  Dr. W. Konya  Dr. M. Michieka  Ms. E. Mwiti