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Building Perinatal Pathology Research Capacity in Sub-Saharan Africa.

Lisa M Bebell1, Joseph Ngonzi2, Frederick A Meier3

  • 1Division of Infectious Diseases, Department of Medicine, Medical Practice Evaluation Center and Center for Global Health, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States.

Frontiers in Medicine
|July 25, 2022
PubMed
Summary
This summary is machine-generated.

A training program in sub-Saharan Africa improved health worker capacity for placental examination, aiding the investigation of stillbirths and neonatal deaths. This initiative enhances diagnostic capabilities in resource-limited settings.

Keywords:
Ugandafetushistologyhistopathologyoutcomesplacentapregnancystillbirth

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Area of Science:

  • Perinatal pathology and diagnostics
  • Global child health outcomes
  • Resource-limited healthcare capacity building

Background:

  • Sub-Saharan Africa faces over two million annual stillbirths and neonatal deaths, with slow progress in reducing perinatal mortality.
  • Placental examination is crucial for diagnosing perinatal death causes but is rarely performed in resource-limited settings.
  • The placenta is vital for fetal development and influences long-term child health.

Purpose of the Study:

  • To develop and implement a training curriculum for health workers in Uganda on placental examination.
  • To build local capacity for placental collection, gross examination, and histological analysis.
  • To improve diagnostics and research capabilities for stillbirths and neonatal deaths in sub-Saharan Africa.

Main Methods:

  • A 4-day didactic/practical curriculum was developed and delivered to train health workers.
  • Training covered placental collection, gross examination, and tissue sampling for histology.
  • A local technician was trained in immunohistochemistry staining.

Main Results:

  • 12 health workers were trained, assessing over 1,000 placentas and collecting over 5,000 tissue samples.
  • 33.3% of placentas were below the 10th percentile for weight, corrected for gestational age.
  • Common diagnoses included acute chorioamnionitis (32.3%) and maternal vascular malperfusion (25.4%).

Conclusions:

  • A targeted training program successfully built capacity at a university-affiliated hospital in sub-Saharan Africa.
  • The trained personnel can independently perform placental collection, gross examination, and tissue processing.
  • This training model is applicable to other resource-limited settings to enhance diagnostic and research capacity for perinatal outcomes.