Report on telepathology meeting, Ile-Ife, Nigeria
Postgraduate Medical Fellowship Training, and by extension, pathology training, began in Nigeria over three decades ago with the establishment of the National Postgraduate Medical College of Nigeria (NPMCN)
- Child in clinical facility in OAUTHC in Ile-Ife.
in 1972. Pathology training colleges in Nigeria include the Faculty of Pathology of the NPMCN and the Faculty of laboratory Medicine of the West African Postgraduate Medical College (WAPMC). The two training colleges have produced more than 300 pathologists in different pathology disciplines. With a population of 140 million people, this number is still very low. As the duration of training lasts on average five years after completion of internship, required for registration, it will take some time to satisfy our needs.
Over 95% of practicing pathologists in Nigeria were trained under these programs, a large majority of whom practice in urban centers.
One approach to solving the problem of the shortage of pathologists is the use of telepathology; a branch of telemedicine that involves the use of telecommunications technology to facilitate the transfer of image-rich pathology data between remote locations for the purposes of diagnosis, education and research (http://www.medterms.com/script/main/art.asp?articlekey=33621).
Telepathology is a low-cost tool for distance diagnosis of pathology cases with the aid of a digital camera-enhanced microscope. It is especially useful in low-resource setting countries, in which practicing pathologists often lack adequate training. In such a situation, materials can be prepared locally, examined, and doubtful cases transmitted by Internet to other pathologists for a second opinion. In some circumstances, photomicrographs prepared by a technician can be sent to a referral center for diagnosis, but in this case additional training regarding image selection is generally necessary.
Telepathology is also a valuable means of exchanging ideas, medical consultation and case discussion even among pathologists in affluent societies.
Telepathology, like telecytology and teleradiology, is fast gaining ground as a versatile medical education tool for both undergraduate and post-graduate medical programs in many parts of the developed world (Lee ES, et al, 2003, Kaplan K, 2004,) and it is also growing in resource-limited societies, where it will turn out to be a very useful diagnostic tool (www.telepatologia.es/9ECT/presentations/Chhut_Vathana.pdf).
- Figure 1. 14 states were represented (darker shading) at the Nigerian Telepathology Meeting in January 2010.
The advantages of telepathology are low cost, simplicity and ready and easy accessibility 24 hours a day from any part of the world. Another advantage is access to any expert, anywhere in the world. Availability of Skype, the free online telephone, is an added advantage if the telepathology system in use does not include audio connectivity.
Static telepathology, (i.e., simply using digital images rather than scanned slides which can be viewed as if on a microscope stage (i.e., moved around and magnified) using computer technology is more commonly used for distributing information globally because of the much smaller file size. It is the system adopted by the University of Pittsburgh (Kaplan K, 2004). One version, known as iPath, was developed and used by the University of Basel, Switzerland (http://telemed.ipath.ch), for medical consultation, teaching and continuous education.
This year, the INCTR facilitated the establishment of an iPath telepathology system at the Obafemi Awolowo University Teaching Hospitals Complex (OAUTHC) in Ile-Ife, Nigeria.
The first meeting of the INCTR program on telepathology in Nigeria was held at the Institute of Public Health, Gates Reproductive Health Unit, College of Health Sciences, OAU, Ile-Ife, Nigeria on January 26th, 2010. The program was coordinated by Dr. Nina Hurwitz of the University of Basel Department of Pathology and director of INCTR's Pathology Education Program. The meeting was opened by the Chief Medical Director of the Obafemi Awolowo University Teaching Hospitals Complex OAUTHC), Ile-Ife, Nigeria, Prof. Olusanya Adejuyigbe, followed by an online live goodwill message to participants from the INCTR President, Prof. Ian Magrath, in Brussels.
Mr. Philip Bojeghire, the Leica representative in Nigeria, demonstrated the use of the digital camera-enhanced microscope recommended for the program. OAU Internet Service personnel were also available. Other facilitators were Dr. K Adelusola, Ile-Ife; Dr. Rose Anorlu, Lagos and Dr. JB Olasode, of the Morbid Anatomy department, OAUTHC, Ile-Ife, Nigeria.
The meeting was attended by 41 participants from 14 states of the country (figure 1), including pathologists, hematologists and hemato-oncologists.
The outcome of the meeting has been very useful, as the host institution acquired the Leica Photomicroscope on the spot, to immediately establish telepathology at OAUTHC, Ile-Ife. Some other participating institutions are making efforts to start the program. The meeting at the Obafemi Awolowo University College of Health Sciences can be regarded as a first step towards the establishment of a national network of telepathology in Nigeria in collaboration with the INCTR. The Director of the Cancer Services in the Federal Ministry of Health, Dr. Patience Osinubi, Abuja and Dr. Dania Simpa, Head Telemedicine Unit, University College Hospital Ibadan, are making great efforts to transform this vision into a reality in the near future.
References available at www.inctr.org
