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OFFICIAL FLAGGING-OFF OF THE OSCC SCREENINGS MOBILE ENDOSCOPY TRUCK IN NYERI COUNTY

KUTRRH Ag. CEO, Dr. Zeinab Gura joined Nyeri County Governor, H.E Mwalimu Mutahi Kahiga, EGH in flagging off the mobile endoscopy truck to support screening services for oesophageal cancer in Nyeri County. The initiative is part of an ongoing research on improving oesophageal cancer survival in Kenya. The Project is funded by the National Institute for Health and Care Research (NIHR) and implemented by KUTRRH in partnership with the University of Manchester, the Christie and NHS Foundation Trust. The project is implemented through a hub and spoke model with KUTRRH being the hub and Nyeri County being one of the participating counties as spokes.

Nyeri County is the second county to have rollout of endoscopy screening services after successful rollout in Meru County. The services are expected to continue through the Month of June in the County. The CEO was accompanied by project’s principal investigator, Prof. George, Njoroge, Training & Research Director, Dr. Caroline Ngugi, and members from the KUTRRH research team.

OFFICIAL FLAGGING-OFF OF THE OSCC SCREENINGS MOBILE ENDOSCOPY TRUCK IN MERU COUNTY

Meru County Health CECM, Dr. Dennis Mugambi presided over the flagging off of a mobile endoscopy truck for screening for the cancer of the oesophagus. The event took place at Mwariama Stadium, Meru County where screening for other cancers was also launched. In his remarks during the flagging off ceremony, Dr. Mugambi noted that the ongoing endoscopy screenings for the cancer of the oesophagus in Meru County courtesy of the National Institute for Health and Care Research (NIHR) and the partners including The University of Manchester, KUTRRH, Manchester Cancer Research Centre, The Christie and Northern Care Alliance NHS Foundation Trusts will go a long way in providing much needed access to the sub-county levels. This from his observations is not only providing much needed opportunities for early detection but also supplementing a constrained capacity for diagnostic services at the County.

Dr. Mugambi urged residents of the county to utilize the recruitment period offered by the research project between 22nd April and 9th May to avail themselves at the nearest level 3 and level 4 hospitals to be checked for onward referral for endoscopy screenings. He further lauded participation by both private and faith-based health facilities in the county in their support for health outreach.

In remarks read on her behalf by the Director, Training & Research, Dr. Caroline Ngugi, KUTRRH CEO, Dr. Zeinab Gura expressed appreciation to the support extended by the NIHR and partnership with The University of Manchester as well as participating Counties and collaborating institutions including JKUAT, National Cancer Institute and KEMRI for making the project rollout a success. Dr. Gura singled out Meru County for the immense support extended to the research team which has led to the progress realized. She reiterated her commitment to foster closer cooperation to address health challenges including collaborative research.

Oesophageal cancer is the fourth most common cancer in Kenya and the third leading cause of death. Unlike other cancers, it has the highest mortality rates largely owing to late diagnosis. This hampers attainment of positive health outcomes as reflected high mortality rates.

The free screening services for oesophageal cancer are part of ongoing research funded by the National Institute of Health and Care Research (NIHR) and implemented by The University of Manchester in partnership with Kenyatta University Teaching, Referral & Research Hospital (KUTRRH) through a hub and spoke model. Meru County is one of the participating counties as spokes for the project. The project also draws collaboration from KEMRI, JKUAT, MKU, and the National Cancer Institute (NCI).

The ongoing project is anchored on three (3) core aims. The first aim entails community engagement and involvement to learn the early signs and symptoms of oesophageal cancer, understanding accessibility of cancer services to community members, and how to build an effective awareness campaign and recruit to a screening service for oesophageal. The second aim entails clinical outcomes unit and telemedicine to establish whether endoscopy screening and early diagnosis in a Hub and spoke model enable best clinical outcome for patients with oesophageal cancer. The third aim of the project involves pathology and early detection signatures through building capacity for high-throughput analysis of specimens to improve early detection of oesophageal cancer, learn about what mutational signatures tell us about the aetiology of oesophageal cancer in Kenya, and find out how the biology of oesophageal cancer in Kenya differs from that in other countries.

The Commencement Of Oesophageal Cancer Research At KUTRRH

Following the receipt of KES 446 million NIHR Oesophageal Cancer Research Grant, KUTRRH alongside our University of Manchester colleagues commenced the project activities in August 2022. The research studies Oesophageal Cancer, establishing the cancer spread in the country, its causes, and the best treatment for best outcomes.

The areas of focus for the project include:

  1. Community engagement and sensitisation
  2. Early detection and screening using mobile endoscopy units
  3. Advanced molecular pathology to inform risk factors of oesophageal cancer
  4. Research capacity strengthening
  5. Training and capacity building of endoscopists, pathologists, and clinical fellows.

Why Oesophageal Cancer Research?

Although present-day therapeutic interventions of surgery, chemotherapy, and radiotherapy can positively influence disease prognosis, cancer of the esophagus remains a highly lethal disease in Kenya. Esophageal cancer is the fourth most common cancer with a fatality rate of 99.3% due to late recognition of symptoms by both patients and health care workers.

Most Esophageal cancers are discovered when they have become locally advanced and are due to a non-specific initial presentation like heartburn or abdominal bloating. Therefore, as few as one out of eight esophageal cancers are detected at an early stage.

Early diagnosis and accurate staging are therefore paramount for optimizing treatment and prognosis of this disease. The cancer is potentially influenced by a combination of genetics, lifestyle, and socioeconomic and environmental factors. Striking variations in incidences exist across geographical confines whereby Western and Central Kenya has the highest incidences.

The two major aims of this Esophageal cancer research include understanding mechanisms of disease progression to identify biomarkers of cancer risk and develop new cancer interception strategies to prevent or delay disease development or recurrence.

Research model

This research adopts a hub and spoke model. KUTRRH will be the Hub and five counties will be the spokes: Kisii, Meru, Garissa, Nakuru, and Nyeri. These have been selected on account of the high prevalence of Esophageal cancer and they have sufficient resources and infrastructure to participate in this program.

The vision of the collaborative research is to reduce the morbidity and mortality from Esophageal cancer in Kenya using a joint approach and based partly on the successes of the University of Manchester teams’ approach to early detection, risk assessment, and stratification, with further expertise in behavior change, health psychology, health economics, data science, and biomarker discovery.

To achieve the vision, this collaborative research is creating an environment where the best clinical and scientific minds can work together with patients and the public to offset the societal, health care, and economic burden of delayed Esophageal cancer diagnosis. The project is set to run for the next three years.