Header image

BEST OF THE BEST ABSTRACT (3)

Tracks
STREAM 2
Tuesday, November 9, 2021
6:30 PM - 7:30 PM
STREAM 3

Speaker

Agenda Item Image
Ms Blessing Raji
Mdoc Healthcare

LEVERAGING HUMAN-CENTRED DESIGN PRINCIPLES TO CREATE A DIGITAL PATIENT NAVIGATION PROGRAM FOR PEOPLE LIVING WITH CANCER IN SUB-SAHARAN AFRICA

Abstract

mDoc is a digital health social enterprise that optimizes the end-to-end care experience for people with regular and chronic health needs by harnessing quality improvement methodologies, data, behavioral science and technology. We provide virtual self-care support through an omni-channel digital platform, CompleteHealth™ to people living with cancer, diabetes, hypertension, overweight. obesity and co-morbid depression and anxiety in Nigeria. In this presentation, we will describe how we refined our web-based CompleteHealth™ platform using the three-phased human centered design process to improve our digital patient navigation program for cancer patients (IDEO, 2015).
In the first phase, the Inspiration phase, to understand and define patients' needs, we interviewed cancer survivors to understand their experiences throughout their cancer care journey. In the second phase, the Ideation phase, we devised solutions for improving the patient journey based on the gaps that we had identified in the first phase. As patient feedback was integral to the final product, these solutions were tested with patients throughout the development process. The final phase, the Implementation phase, is not over yet as it is a phase of continuous learning which involves regularly upgrading the CompleteHealth™ platform, based on patients' response to the virtual program.
Human centered design is an essential process to ensure that digital navigation programs for cancer are accessible, available and acceptable to improve the quality of healthcare to people living with cancer, their families and caregivers in Sub-Saharan Africa. We have been able to successfully set up and run the digital patient navigation program for people living with cancer using HCD and will be showing patient outcomes as well as results from our patient satisfaction survey and our self-efficacy survey.
Agenda Item Image
Dr Christian Abnet
National Cancer Institute

THE AFRECC GWAS OF ESOPHAGEAL CANCER IN AFRICA

Abstract

OBJECTIVE: Esophageal squamous cell carcinoma (ESCC) is a common cancer in Eastern and Southern Africa. Prior genome wide association studies (GWAS) in people of Chinese ethnicity suggest that this cancer is highly heritable. In addition to the etiologic insight that can be revealed by GWAS, the strengths of association in prior studies suggest that these results may serve as the basis for a polygenic risk score for ESCC.
METHODS: We are assembling ESCC cases and controls from sites recruiting subjects for epidemiologic studies in multiple countries including Ethiopia, Kenya, Tanzania, Zambia, and Malawi that collaborate in the African Esophageal Cancer Consortium (AfrECC) . The study will use DNA collected from blood or salvia and self-reported data on sex, age, ethnic group, tobacco smoking, and alcoholic beverage consumption. Biological samples and data are being consolidated at the US National Cancer Institute. Genotyping will be completed using the H3Africa Consortium Array, which contains >2.2 M markers. Analyses will use standard GWAS methods adapted for the substantial genomic heterogeneity across these diverse populations.
RESULTS: To date, we have identified and collected about 2000 cases and controls from case-control studies in the noted countries. Subject accrual continues at multiple sites, building a larger sample set for future discovery and validation studies. Additional esophageal cancer case and control samples from other study sites will be welcomed to enhance the overall study. An independent ESCC GWAS (Mathew CG personal communication) in South Africa will offer a chance for mutual replication.
CONCLUSIONS: The AfrECC consortium GWAS has assembled a large, diverse collection of ESCC cases and controls and should provide novel genetic insights into the esophageal cancer risk in Africa.
Agenda Item Image
Dr Moussa Ndiaye

GENE EXPRESSION PROFILING IN PERIPHERAL BLOOD CELLS FROM AFRICAN WOMEN WITH CERVICAL LESIONS REVEALS NEW MARKERS OF CANCER PROGRESSION

Abstract

Objective: Despite the introduction of cervical smear screening and the use of HPV vaccination, cervical cancer still remains a major public health problem. The objective of this work was to search for prognostic biomarkers in patients with cervical cancer, genes involved in cancer severity and eventual progression to cancer in patients with precancerous cervical lesions, type CIN1.

Methods: We performed transcriptomic analysis of PBMCs using Illumina microarrays from patients with cervical cancer (CC, N=31), cervical intraepithelial neoplasia (CIN1, N=27), and healthy control subjects (CTR, N=29). Microarray data were log-transformed to base 2. Quantile normalization was applied. Student's t test was performed to identify differentially expressed genes (DEGs) (p < 0.05) by making comparisons between cancer and dysplasia cases, controls, and also between dysplasia cases and controls. The p-values were adjusted according to the Bonferroni method and compared at the significance level.
Genes expressed at significantly different levels between patients and controls were analysed by hierarchical clustering to visualize the correlation of co-expressed genes.
To search for metabolic pathways associated with cancer, we applied gene ontology analysis in the String protein database.

Results: Few differences were observed between CIN1 and CTR patients. In contrast, 1569 genes were highly expressed in CC patients based on comparisons with CIN1 and CTR patients. Several genes upregulated in CC patients, such as DUSP1, DDIT4, and FKBP, have been previously associated with cancer. Compared with CTR and CIN1 subjects, there was high expression of genes involved in immunity and low expression of genes related to metabolism in CC patients.

Conclusion: In this first large transcriptomic study on cervical cancer performed on PBMCs and African patients, we identified a set of genes that could be relevant blood biomarkers for monitoring CIN1 and CC and that could help develop new monitoring strategies at both diagnostic/prognostic and therapeutic levels.
Agenda Item Image
Prof Jean-Pierre Droz
Centre Hospitalier Ouest-Guyane

LIMITS OF G8 FRAILTY SCREENING IN OLDER PATIENTS WITH CANCER IN FRENCH GUAINA

Abstract

Objective: the G8 score was constructed in western countries to screen the need for geriatric assessment in older patients with cancer: is it applicable in multicultural and multilingual countries? French Guiana is a multicultural territory: western, Maroon, Native Amerindian, and Creole cultures.
Methods: the G8 score was achieved in 116 out of 203 and 78 out of 107 older patients with cancer at Cayenne (CH) and Saint-Laurent du Maroni (SLMH) hospitals, respectively. The passage of the test was non-directive at CH, directive at the SLMH without and with the help of a cultural mediator respectively.
Results: In both populations only 15% of patients had a G8 score ≥ 15/17. But within the G8 score items, we observed that to the question "In comparison with other people of the same age, how does the patient consider his / her health status? “, 64% and 20% of patients at CH and SLMH respectively cannot respond. In an analysis in 60 patients with detailed G8 score information in CH : 1- language had a statistically significant impact: 18/24 patients who did not speak French could not answer this question (even with a translator) versus 14/36 who did speak French (p= 0.01); 2- culture had no significant impact on the ability to respond: 17/38 patients of Guianese culture, including 13/34 French speakers, were unable to answer this question, compared with 16/22 patients of other cultures (p= 0.07)
Conclusion: Self-assessment of health status may be less appropriate in countries of non-western cultures, especially those with low levels of education, multilingualism, and multiculturalism. Another option than G8 score is a tool with items based mainly on functional screening and adapted to different languages, cultures, and countries. We conclude that research should be conducted in non-western countries to enable frailty screening testing through translation and cultural adaptations.
Agenda Item Image
Miss Valerie Otti
University of Chicago

CULTURALLY ADAPTING VIDEOS TO INVOLVE NIGERIAN PATIENTS WITH CANCER IN CLINICAL TRIALS

Abstract

Low health and clinical trial literacy among Nigerian patients have been sighted as significant barriers to ensuring that patients enrolled on clinical trials are truly informed. Video intervention has been shown to be the most proactive method to improving patient’s clinical trial knowledge. Thus, this study aimed to apply and adapt video interventions addressing attitudinal barriers peculiar to Nigerian patients. A hospital-based representative mixed method study was conducted at the Lagos State University Teaching Hospital (LASUTH) from July to December 2020 comprising of 63 cancer patients aged 18 and above. We first administered a cancer literacy survey to determine patients’ knowledge about clinical trials. For patients’ who had prior knowledge, a pre-intervention test was administered, after which a 15-minute video (Attitudes and Intention to Enroll in therapeutic clinical Trials (AIET)) was played, and then ended by administering a post-intervention test. For patients who had no prior knowledge, the AIET video was played for them, followed with the post-intervention test. Out of 63 patients sampled, 43 (68.3%) had breast cancer. On average, patients agreed to understanding their cancer diagnosis and treatment very well. 84.1 % of patients had never heard about cancer clinical trials and 85.7% did not know what cancer clinical trials were. There was a strong positive relationship (r=0.916) between the pretest and posttest, which means that the intervention improved patients’ knowledge, perception, and attitudes about cancer clinical trials. In the focus groups, patients recommended adapting the video in Nigerian settings and representing all religions, in order to address trust in local clinical trialists. Due to small size of patients, change in clinical trial knowledge was not statistically significant. However, there is a trend suggesting that culturally adapted video interventions can be used to improve knowledge and perception about cancer clinical trials.
loading