Alfred Karagu

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Howard Nusbaum

University of Chicago

Krishna Prasad Miyapuram

Indian Institute of Technology Gandhinagar

Renee Spencer

Boston University

Deniz Yonucu

Newcastle University

Panas Karampampas

EHESS-Ecole des hautes études en sciences sociales

john van der kamp

Vrije Universiteit Amsterdam

Klaniczay Gabor

Central European University

Dr. Sandeep Jagdale

Solapur university

Bieke Gils

Universitetet i Sørøst-Norge / University of South-Eastern Norway

wycliffe njororai simiyu

University of Texas at Tyler

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Papers by Alfred Karagu

Mapping Stakeholders to Enhance Coordination of Cancer Prevention and Control: The Kenyan Experience

Journal of Global Oncology, Oct 1, 2018

Background: Coordination of stakeholders in cancer prevention and control ensures prudent use of ... more Background: Coordination of stakeholders in cancer prevention and control ensures prudent use of available resources toward a common goal while limiting overlaps and redundancies. The National Cancer Institute of Kenya (NCI-K) is a statutory body with an overall mandate to coordinate and centralize all activities related to cancer prevention and control in Kenya. To identify baseline status of cancer control stakeholder activity to guide implementation of the National Cancer Control Strategy, NCI-K collaborated with US National Cancer Institute (NCI-US) to map stakeholders involved in cancer control in Kenya. Aim: The survey set out to determine the geographical distribution, scope of cancer prevention and control activities, and sources of financing for identified stakeholders involved in cancer prevention and control in Kenya. Methods: Between October 2017 and March 2018, we conducted an online survey among stakeholders involved in cancer prevention, research and control in Kenya adapted from similar stakeholder mapping activities coordinated by NCI-US in other settings. Using attendance lists to past multisectoral forums organized by NCI-K, Kenyan Ministry of Health, and NCI-US, a Google link to a standard pretested questionnaire was circulated. Descriptive analysis was conducted using Microsoft Excel. Results: A total of 52 responses were received with 38 respondents reporting Kenya as their institution country. Twenty (38%) had ongoing activities in all the counties in Kenya. Nairobi County had the highest reported number of active institutions (19) followed by Kisumu (16) and Uasin Gishu (10). The three program focus areas most reported were training 28 (54%), clinic-based screening 27 (52%) and advocacy/information and educational 26 (50%), while the least reported was financing 12 (23%). For organizations involved in cancer screening, 22 (81%) focused on breast cancer while 18 (67%) prioritized cervical cancer. Among the programs that identified cancer prevention as one of their focus areas, a large majority (91%) were involved in health education, while only 1 organization focused on environmental control activities. The most reported source of funding for the cancer programs was grant funding 17 (33%). Conclusion: This stakeholder mapping activity has identified a strong stakeholder presence in most parts of the country while also highlighting gaps in the focus of cancer prevention and control programs. This baseline information on stakeholder activity will help shape future collaborations in cancer prevention and control and will guide NCI-K in developing appropriate policies and ensuring effective coordination.

Histology and Cytopathology Capacity in the Public Health Sector in Kenya

Journal of Global Oncology, Dec 1, 2018

BACKGROUND Cancer is a significant cause of mortality in Kenya; it is estimated that in 2012, the... more BACKGROUND Cancer is a significant cause of mortality in Kenya; it is estimated that in 2012, the number of new cancer cases was 40,999 with a mortality of 28,500. 1 For a majority of cases, the diagnosis of cancer requires a functional pathology laboratory. However, despite its importance, there has been no previous effort to provide a detailed description of the capacity of histology and cytopathology, which, for the purposes of this study, refers to fine-needle aspiration (FNA) and bone marrow aspiration (BMA) services in Kenya. Registry data from Nairobi County show that 85% of patients treated for cancer between 2004 and 2008 had a tissue diagnosis, 2 but this figure is probably artificially elevated as a result of the reliance of the registry on pathology laboratories as a data source, causing patients who are unable to access pathology services to be less likely to be captured in the registry. In addition, the Nairobi registry only captures data on citizens who reside in the capital county, where access to pathology services is significantly greater than in the rest of the country. Previous studies report that in Kenya, the pathologist to population ratio is 1 to > 725,000. 3 Given this shortage of available pathology services, it is imperative that investments are made to ensure that the available resources are used as efficiently as possible so that the entire population has access to accurate and efficient cancer diagnostics. Strengthening the capacity of pathology services is a priority of both the Kenyan Ministry of Health (KMOH) and the National Cancer Institute of Kenya (NCI-K). In the first half of 2017, KMOH and NCI-K led a multistakeholder effort to write a new national cancer control strategy that will guide the country in its cancer control efforts from 2017 to 2022. 4 A key priority of the Cancer Diagnosis, Registration and Surveillance section Purpose Histology and cytopathology services are necessary for cancer diagnosis and treatment. However, the current capacity of Kenya's pathology laboratories is unknown. A national survey was conducted among public sector pathology laboratories to assess their capacity to perform histology, fine-needle aspiration, and bone marrow aspiration.

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Development of a National Cancer Registry in a Low Resourced Country: The Case of Kenya National Cancer Registry Programme

Journal of Global Oncology, 2018

Background: Population-based cancer registration represents the gold standard for the provision o... more Background: Population-based cancer registration represents the gold standard for the provision of information on cancer incidence in a defined population (Bray F, et. al, IARC Technical Report No. 43). In Kenya, the incidence and prevalence of cancer has not been well documented. The existing population-based cancer registries (PBCRs) cover less than 10% of…

Developing a National Cancer Control Plan Through Effective Partnerships: A Case of Kenya National Cancer Control Strategy 2017-2022

Journal of Global Oncology, 2018

Background and context: A National Cancer Control Strategy (NCCS) provides a strategic framework ... more Background and context: A National Cancer Control Strategy (NCCS) provides a strategic framework that guides the systematic approach toward cancer prevention and control based on the existing cancer burden, risk factor prevalence and available resources. Though Kenya developed her first Kenya National Cancer Control Strategy in 2011, its implementation was characterized with various shortcomings. Aim: The Kenyan Ministry of Health set out to develop the second edition of the National Cancer Control Strategy with a focus on greater partnerships, evidence-based interventions and shared accountability of roles informed by lessons learnt from the NCCS 2011-2016. Strategy/Tactics: The Head of the National Cancer Control Program at the Ministry of Health was identified as the National Coordinator to lead the process and keep each stakeholder on track. A clear road map for developing the strategic plan was drawn with specific timelines. The process was further aligned to the Ministry of He...

The Kenya cancer research and control stakeholder program: Evaluating a bilateral partnership to strengthen national cancer efforts

Journal of Cancer Policy, 2017

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Towards a unified approach for multiple myeloma care in Kenya - proceedings of the Inaugural Multiple Myeloma Congress

by Mercy Oduor, Kelvin Manyega, and Alfred Karagu

Pan African Medical Journal, 2021

The rising burden of multiple myeloma in Kenya has not been met by a commensurate effort for cont... more The rising burden of multiple myeloma in Kenya has not been met by a commensurate effort for control. Patients and practitioners struggle with unavailability and unaffordability of diagnostics, drugs and stem cell transplant leading to presentation at advanced stages and under-treatment with increased morbidities and mortality. A concerted effort among stakeholders is urgently needed to develop strategies for myeloma control. The scarcity of providers also carries grave consequences for Kenyan patients. The Academic Model Providing Access To Healthcare (AMPATH) multiple myeloma program organized the Inaugural Virtual Multiple Myeloma Congress to achieve both interactive specialist instruction and stakeholder engagement. Expert presenters and panellists from diverse disciplines were invited to offer in-depth presentations on myeloma care and case studies from panellists´ practice were used to contextualize learning points and form a basis for generating debate on the challenges facing providers and opportunities for care improvement. An audience of health professionals offering care to myeloma patients was invited. The underlying principle of recommendations developed during the congress was collaboration among in-country and international practitioners, researchers and policy experts from private and public sector. This partnership of stakeholders bears the potential of pooling scarce resources and for collective advocacy towards better patient care

Abstract 114: Funders and Collaborators of Cancer Research in Kenya, 2007-2017: A Bibliometric Analysis

by martha maina and Alfred Karagu

Cancer Epidemiology, Biomarkers & Prevention, 2021

Purpose: It is well established that cancer research is essential to the development and implemen... more Purpose: It is well established that cancer research is essential to the development and implementation of effective control strategies and interventions. In Kenya, cancer is the third leading cause of death. Country specific research conducted by both local and international investigators has the potential to shape a national plan which addresses local needs across the cancer care continuum. This analysis aims to provide information about the trends in research collaborations, funding and outputs from 2007-2017 types of research collaborations, institutional and individual research collaborations, the types of cancer in order to understand gaps and opportunities to strengthen Kenya-led cancer research capacity. Methods: This analysis included 243 studies from a previously published phase 1 scoping review of oncology research conducted in Kenya from 2007-2017. The citation metadata was drawn from Pubmed and manually standardized in Microsoft Excel. Using Sci2, a series of bibliometr...

Barriers to effective childhood cancer control in Kenya (BECK) study, 2019-2020: A mixed methods study in a national tertiary facility and 10 regional cancer treatment centers

Journal of Clinical Oncology

10018 Background: Globally, 80,000 children die from cancer annually; 80% in low- and middle-inco... more 10018 Background: Globally, 80,000 children die from cancer annually; 80% in low- and middle-income countries (LMICs). Childhood cancer cure is possible in more than 80% of cases, in all economic settings. This study aimed to identify barriers to effective management of childhood cancers in Kenya, for program and policy intervention. Methods: We reviewed childhood cancer cases diagnosed at Kenyatta National Hospital in the period 2015-2019. We also assessed capacity of ten recently established regional cancer centres for childhood cancer diagnosis and treatment. We conducted focused group discussions among childhood cancer survivors’ caregivers and key informant interviews among childhood cancer specialists and policy makers from the Ministry of Health and the National Cancer Institute of Kenya. We estimated diagnostic delays, mapped service availability and deductively summarized the qualitative data into main themes. Results: We abstracted 1,764 cases; median age 6 years (IQR 9); ...

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Abstract 114: Funders and Collaborators of Cancer Research in Kenya, 2007-2017: A Bibliometric Analysis

Cancer Epidemiology, Biomarkers & Prevention, 2021

Creation of Minimum Requirements Guidelines for Cancer Centers in Kenya

Journal of Global Oncology, 2017

39 Background: Cancer is a leading cause of mortality worldwide and accounts for nearly 8.5 milli... more 39 Background: Cancer is a leading cause of mortality worldwide and accounts for nearly 8.5 million deaths—more than malaria, tuberculosis, and HIV combined. In Kenya, the majority of cancer care is provided at two national referral hospitals, but there is growing interest by various counties in managing patients with cancer locally. However, there are currently no national standards to describe the minimum requirements for a health facility that wishes to offer cancer management services. Beginning in 2015, the US National Cancer Institute’s Center for Global Health (CGH) has assisted the Kenyan Ministry of Health (MoH) and the Kenyan National Cancer Institute (NCl-K) in creating national guidelines for minimum requirements for facilities that wish to offer cancer services in Kenya. With this work, we report the MoH and NCI-K minimum requirements in infrastructure, equipment, and human resources needed for facilities that offer cancer services in Kenya. Methods: Technical experts w...

A bibliometric analysis of cancer research funders and collaborators in Kenya: 2007–2017

Journal of Cancer Policy

Towards a unified approach for multiple myeloma care in Kenya - proceedings of the Inaugural Multiple Myeloma Congress

Pan African Medical Journal

Haematological malignancies in sub-Saharan Africa: east Africa as an example for improving care

The Lancet Haematology

Moving Toward an Evidence-Informed Cancer Control Strategy: A Scoping Review of Oncology Research in Kenya

JCO Global Oncology

PURPOSE In 2017, the Kenya Ministry of Health launched the National Cancer Control Strategy 2017 ... more PURPOSE In 2017, the Kenya Ministry of Health launched the National Cancer Control Strategy 2017 to 2022. A scoping review of oncology research in Kenya was conducted to understand the scope of—and gaps in—existing research and inform the development of the national cancer research agenda. METHODS We searched PubMed/MEDLINE, Embase, Scopus, and Global Health databases using controlled vocabulary and keywords to identify oncology research with a study site in Kenya, published in English, from 2007 to 2017. Fifteen journals and additional gray literature sources were hand searched. Screening of titles, abstracts, and full text was completed by pairs of 2 reviewers, with a third reviewer reconciling discrepancies. From included studies, data were extracted and coded using Google Forms. Microsoft Excel was used for descriptive statistics. RESULTS Of the 284 included articles, a majority were analytic observational studies (66.9%). The top 5 cancers studied were cervical cancer (n = 106;...

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Moving towards an evidence-informed cancer control strategy: A scoping review of oncology research in Kenya

Journal of Cancer Policy

Histology and Cytopathology Capacity in the Public Health Sector in Kenya

Journal of global oncology, 2018

Histology and cytopathology services are necessary for cancer diagnosis and treatment. However, t... more Histology and cytopathology services are necessary for cancer diagnosis and treatment. However, the current capacity of Kenya's pathology laboratories is unknown. A national survey was conducted among public sector pathology laboratories to assess their capacity to perform histology, fine-needle aspiration, and bone marrow aspiration. Between April and June 2017, we identified all public hospitals that provide pathology services in Kenya. In total, two national and 13 county referral hospitals met the inclusion criteria and were sent a standardized, pretested, self-administered questionnaire. A total of 11 hospitals (73%) completed the survey. The reported total caseload of histology, fine-needle aspiration, and bone marrow aspiration for 2016 was 26,472. All of the facilities staffed a pathologist and were providing cancer-related diagnostic services. Nine (82%) of the hospitals maintain a register of diagnosed cancer cases, but only one (11%) of those uses an electronic system...

Research for Actionable Policies: implementation science priorities to scale up non–communicable disease interventions in Kenya

Journal of Global Health, 2017

Similar to other Sub-Saharan African countries, Kenya is experiencing an explosive growth in NCDs... more Similar to other Sub-Saharan African countries, Kenya is experiencing an explosive growth in NCDs, especially those related to cancer and cardiovascular diseases [3]. There is therefore an urgent need to determine implementable interventions to reduce the growing burden from these and other NCDs, including respiratory diseases, injuries and mental health. Although there are many ongoing research studies and demonstration programs [4], it is not clear whether these activities address the Kenyan Government' s evidence needs and priorities to support their NCD strategy [5].

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Mapping Stakeholders to Enhance Coordination of Cancer Prevention and Control: The Kenyan Experience

Journal of Global Oncology, Oct 1, 2018

Histology and Cytopathology Capacity in the Public Health Sector in Kenya

Journal of Global Oncology, Dec 1, 2018

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Development of a National Cancer Registry in a Low Resourced Country: The Case of Kenya National Cancer Registry Programme

Journal of Global Oncology, 2018

Developing a National Cancer Control Plan Through Effective Partnerships: A Case of Kenya National Cancer Control Strategy 2017-2022

Journal of Global Oncology, 2018

The Kenya cancer research and control stakeholder program: Evaluating a bilateral partnership to strengthen national cancer efforts

Journal of Cancer Policy, 2017

Download

Towards a unified approach for multiple myeloma care in Kenya - proceedings of the Inaugural Multiple Myeloma Congress

by Mercy Oduor, Kelvin Manyega, and Alfred Karagu

Pan African Medical Journal, 2021

Abstract 114: Funders and Collaborators of Cancer Research in Kenya, 2007-2017: A Bibliometric Analysis

by martha maina and Alfred Karagu

Cancer Epidemiology, Biomarkers & Prevention, 2021

Barriers to effective childhood cancer control in Kenya (BECK) study, 2019-2020: A mixed methods study in a national tertiary facility and 10 regional cancer treatment centers

Journal of Clinical Oncology

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Abstract 114: Funders and Collaborators of Cancer Research in Kenya, 2007-2017: A Bibliometric Analysis

Cancer Epidemiology, Biomarkers & Prevention, 2021

Creation of Minimum Requirements Guidelines for Cancer Centers in Kenya

Journal of Global Oncology, 2017

A bibliometric analysis of cancer research funders and collaborators in Kenya: 2007–2017

Journal of Cancer Policy

Towards a unified approach for multiple myeloma care in Kenya - proceedings of the Inaugural Multiple Myeloma Congress

Pan African Medical Journal

Haematological malignancies in sub-Saharan Africa: east Africa as an example for improving care

The Lancet Haematology

Moving Toward an Evidence-Informed Cancer Control Strategy: A Scoping Review of Oncology Research in Kenya

JCO Global Oncology

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Moving towards an evidence-informed cancer control strategy: A scoping review of oncology research in Kenya

Journal of Cancer Policy

Histology and Cytopathology Capacity in the Public Health Sector in Kenya

Journal of global oncology, 2018

Research for Actionable Policies: implementation science priorities to scale up non–communicable disease interventions in Kenya

Journal of Global Health, 2017

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