Pattern of head and neck cancers among patients attending Muhimbili National Hospital Tanzania

Background: It is estimated that there are more than 640,000 new cases and 350,000 deaths due to head and neck cancers (HNCA) each year worldwide. Lack of baseline data in Tanzania concerning head and neck malignancies makes it difficult to appreciate the pattern and magnitude of the problem in the country. The objective of this study was to determine the pattern of head and neck cancers among patients attending the Otorhinolaryngology Department at the Muhimbili National Hospital in Dar es Salaam, Tanzania.Methods: All inpatients and outpatients with histologically proven malignant lesions in the head and neck region who attended the Otorhinolaryngology department of Muhimbili National Hospital between 1st July 2012 and 31st January 2013 were enrolled in the study. A special designed questionnaire was used for data collection. Clinical examination, computed tomography scan and/or magnetic resonance image were done accordingly, followed by fine needle aspiration cytology and/or tissue biopsy. Results: A total of 113 patients, 75 (66.3%) males and 38 (33.7.0%) females with a male to female ratio 2:1 were involved in the study. The mean age at the time of diagnosis was 51±18. Patients below age of 40 years accounted for 28.4% of all head and neck cancer patients. The commonest observed anatomical location was nasal and paranasal sinuses (23.9%) followed by the larynx (20%). Carcinoma accounted for 94% of head and neck cancers in which squamous cell carcinoma was the most frequent (74%). Lymphoma (2%) was the least frequent histological variant encountered. Nasal and paranasal sinuses had the most histological variations of all anatomical locations of head and neck cancer.Conclusion: This study shows a significant number of head and neck cancer patients in a younger generation and a high magnitude of sinonasal cancerrelative to other head and neck cancer

Cochlear implantation and outcomes in a resource–limited setting: experience from Tanzania

Introduction: Cochlear Implant is a small medical electronic device that is surgically inserted partially in the cochlear (inner ear) to restore some hearing in patients with severe to profound hearing loss. Cochlear implantation is considered a rehabilitative measure of choice that positively impacts on the quality of life of patients.Objective: The objective was to describe the clinico-demographic characteristics of cochlear implantees and the outcomes of the intervention among the implantees at Muhimbili National Hospital (MNH) in Tanzania.Method: This was a hospital based cross-sectional study which involved a total of 39 patients who underwent cochlear implantation from July 2017 to May 2021 at MNH. Clinico-demographic characteristics and outcomes of the intervention among the implantees were collected using structured questionnaires and data were analysed using Statistical Package for Social Sciences Version 20. Results were then presented in frequency tables and figures.Results: This study recruited 39 patients with bilateral hearing loss with their ages ranging from 2 to 55 years. Their mean age was 4.7 years and median of 3 years. More than half, 24(61.5%) of implantees aged 2-3 years. Males predominated with male to female ratio of 1.2:1. Majority 37(94.9%) had pre lingual hearing loss and 36 (92.3 %) had bilateral profound sensorineural hearing loss. Ototoxicity was the commonest cause of hearing loss among the implantees contributing 16(41%) followed by birth asphyxia, 8(20.5%). A total of 37(94.9%) of these patients were implanted with a single cochlear device due to the high cost associated with this type of intervention.Conclusion: Cochlear implantation in limited resource settings is possible and cost effective if there is enough support from the government and other charitable organisations. The availability of rehabilitative services remains key for better outcome after cochlear implantation