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It Takes a Village: Providing International Pediatric Pathology Services in a Resource-Limited Setting

Amanda M Hopp1,2, Julie E Tetzlaff1,2, Kyle Kopidlansky1

  • 1Department of Pathology, Children's Wisconsin, Milwaukee, WI, USA.

American Journal of Clinical Pathology
|January 20, 2022
PubMed

Insights

Pathology partnerships between low-income (LMIC) and high-income countries (HIC) improve diagnostics. A collaboration between Angkor Hospital for Children and Children's Wisconsin demonstrated significant impact on patient management through remote pathology interpretations.

Area of Science:

  • Global Health
  • Medical Diagnostics
  • International Collaboration

Background:

  • Health disparities persist between low- to middle-income countries (LMICs) and high-income countries (HICs).
  • Limited healthcare resources, including pathology services, in LMICs like Cambodia's Angkor Hospital for Children (AHC) exacerbate these disparities.
  • Partnerships between LMICs and HICs offer a strategy to address these inequities.

Purpose of the Study:

  • To describe the established pathology workflow in a partnership between AHC (LMIC) and Children's Wisconsin (CW, HIC).
  • To examine pathology cases from AHC patients interpreted by CW.
  • To evaluate the impact of CW's pathology interpretations on patient management at AHC.

Main Methods:

  • AHC provided clinical information and shipped specimens to CW for processing and interpretation.
  • Pathology reports were electronically transmitted from CW to AHC.
  • Diagnoses were categorized as concordant, refined, or discordant; management changes were tracked.

Main Results:

  • 347 specimens were analyzed (177 malignant, 146 benign, 24 insufficient).
  • 31% of diagnoses were discordant with the initial clinical impression.
  • CW's interpretations led to a change in management for 44% of cases with clinical follow-up.

Conclusions:

  • Integrating pathology services into LMIC-HIC partnerships is vital for reducing health disparities.
  • The described pathology workflow is adaptable to various institutional needs and resource levels.
  • Such collaborations enhance diagnostic capabilities and patient care in resource-limited settings.
Abstract

Keywords:
Global healthHistologyManagement/administrationPediatricsQuality

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