Opening a histopathology laboratory in Kampala Uganda – from the ground up

Abstract

Cancer is an increasing threat to the health of individuals in low- and middle-income countries (LMIC), with two-thirds of cancer cases projected to occur in these regions by 2020. With growing options for cancer treatment in LMIC, establishing an accurate pathologic diagnosis of cancer is an urgent global health priority but is not possible in many LMIC. The Fred Hutchinson Cancer Research Center has a longstanding collaboration with the Uganda Cancer Institute (UCI) located in Kampala, Uganda. In May 2015, state-of-the-art cancer treatment, research, and education center was opened on the UCI campus that includes outpatient adult and pediatric clinics, research clinic, training facilities, chemotherapy infusion rooms, and diagnostic laboratories including a histopathology lab. Extensive efforts were made to build the capacity to provide accurate histologic diagnoses for cancer at the new facility. These efforts included extensive planning during the construction of the new facility to accommodate a histopathology laboratory, training of histology technicians, developing resource-appropriate laboratory protocols, identifying sources for high-quality reagents, consumables and equipment support, and rigorous quality control. These activities have resulted in a functional laboratory capable of grossing, fixation, paraffin processing, embedding, sectioning, and basic staining (hematoxylin and eosin) of clinical specimens to render cancer diagnoses in Uganda. Future capabilities of the laboratory will seek to expand staining to include immunohistochemistry, and to build the infrastructure for robust telepathology with international colleagues.