Program committee

Co-Directors
Manzoor Ahmed and Lorenzo Leoncini

Committee Members
Lorenzo Leoncini, Manzoor Ahmed, Nina Hurwitz, Martine Raphaël, Kikkeri Naresh, Shaheen Sayed

Advisors/Faculty
see below

Communication
Mostly through e-mails and conference calls. The committee will hold telephone conference calls on a monthly basis and meet in person once every four-six months.

Progress and Prospects

Most of the goals are ongoing and need continued input. Annual reports will be prepared.

Achievements during the last year and targets for the next six months are detailed below:

1. Breast cancer reporting protocol drafted by Dr. Mazoor Ahmad.
2. Site visits to pathology laboratories in the last year: Lacor Hospital, Uganda; Kenyatta National Hospital and Aga Khan Hospital, Kenya; Muhimbili Hospital, Tanzania; Obafemi Awolowo University Teaching Hospitals Complex (OAUTHC), Ile-Ife, Nigeria; Ibadan University Hospital, Nigeria, and several pathology laboratories in Yaoundé, Cameroon. During these visits, INCTR pathologists identified problems and challenges to optimal pathology practice. A central review of lymphoma cases that have been entered into INCTR 03-06 protocol along with other cases not eligible for the protocol was undertaken. Discussions on the diagnosis of specific cases were held at each center visited. Following these visits, African colleagues have sent formal referrals of difficult cases to London, Sienna and Paris for second opinions, which have been provided.
3. Actions realized by the pathology section of the INCTR Program for "Online Consultation and Continuing Education in Pathology, Hematology and Clinical Oncology":  
   1. Pilot centers for telepathology have been established in Nairobi (local Director Jessie Githanga), Dar-es-Salaam (local Director Herbert Nguvumali), and Ile-Ife (local Director Kayode Adelusola).
   2. An international INCTR Faculty for Pathology has been created, presently consisting of 40 members from ten Western and African countries covering all subspecialities in pathology. The scope of the involvement of the Faculty includes:
      1. Online consultations on cases in their fields of special interest.
      2. Online support to improve histologic/cytologic techniques.
      3. Performing special investigations not available in the laboratories of origin.
      4. Support in introducing new methods (e.g., molecular techniques).
      5. Online case discussion and lectures; support in the preparation of publications.
      6. Site visits (where feasible and funding is available).
   3. Faculty Members will choose the degree of her/his involvement within the above mentioned activities. Two of the cases recently discussed in iPath will be presented at the Meeting of the Association of Pathologists from  East, Central and Southern Africa (APECSA) in Kampala.
   4. Several African centers suitable  for the training of laboratory personnel in histologic and cytologic thechnique have been identified.
   5. A Nigerian Federal Telemedicine Project has been launched in collaboration with the INCTR. In the first stage it will run in 55 tertiary hospitals. Coordinator: Dania Simpa, University of Ibadan.
4. We hope to initiate immunohistochemistry laboratories in three or four centers in Africa within the next year. Our intention is to develop centers within Africa that would be able to train technologists and biomedical scientists from other centers in Africa.
5. A two-day meeting on lymphomas in Africa entitled "What we can Learn from Africa" was organized primarily by Lorenzo Leoncini with the help of the program committee and was held in Sienna during the first week of May 2010. There was large and active participation from African colleagues who presented cases from their centers that could not be diagnosed in Africa. Additional studies were performed and the diagnoses revisited with assistance of colleagues from Europe. In addition, summary lectures on the latest WHO classification of lymphomas and on the diagnosis of each lymphoma subtype were given.
6. An image gallery of common lymphomas in Africa along with a list of critical criteria for diagnosis was available during and after the Sienna meeting.
7. The INCTR supported by the International Academy of Pathology is planning to hold an educational meeting in January 2011 for technicians and young pathologists in East Africa. This will include a three-day meeting in Dar-es-Salaam and a three-day meeting in Nairobi.
8. We would like to establish fellowship programs in pathology and will be seeking help from several granting agencies. Since the visit, one UICC/ICRETT fellow has been hosted in the University of Sienna in April 2010.

Funding approaches

• Capacity-building grants.
• Research grants which would support infrastructure.
• Educational grants to undertake visits and to hold educational meetings.
• Grants to support fellowship programs.
• Incorporation of pathology review programs within the INCTR’s clinical research projects.

Lorenzo Leoncini, Manzoor Ahmed, Nina Hurwitz, Martine Raphaël and  Kikkeri Naresh
INCTR Pathology Program