HISTO AND CYTO-PATHOLOGIC DIAGNOSES AT A RURAL HOSPITAL IN KENYA

Abstract

Background: Cancer has emerged as one of the common causes of morbidity and mortality
in rural areas and as a major cause of premature deaths.
Objectives: To provide histo-pathology and cyto-pathology data in a rural district hospital
and highlight on the common malignancies seen in a rural setting in Kenya.
Design: Prospective study.
Setting: Histopathologv Department, Machakos Provincial Hospital, Machakos district,
Kenya.
Subjects: Two hundrend and sixty eight patients referred to Machakos laboratory for
histopathology, fine needle aspirate or pap smear cyto-pathology were analysed.
Maill outcome measures: Staining with routine stains such Pap stain, Haeomatoxylin and
Eosin was effective method of making a primary accurate and definitive histo-pathology and
cyto-pathology diagnosis in a rural district hospital setting.
Results: Histo-pathology biopsies comprised 71.6% of the total slides seen. Pap smear
cervical cytology cumprisd 13.8% while fine needIe aspirate and post- rnortem biopsies
comprised 12.39'~~ 2.2% respectivety. The commonest histo-pathology biopsies seen were
breastmmprising 24% ofthe total cases,fdowed by endometrium contributing 14.9%,then
followed by skin 1 1.58, tymph node 11S%, cervical 11 %, and gastrointestinal 6.3 %. Most
of pap smear cyto-pahology showed evidence of infection cornpising 54% while fine needle
aspirate infections and malignancy showed equal rate 24% of d l cyto-pathology seen during
this study.
Conclusions: This is the first time histo-pathology and cyto-pathology data have been
provided from a rural district hospital setting in Kenya. The malignant and pre-malignant
pattern seen at hlachakos General Hospital may be used to gain a broader picture of the
common malignant conditions prevalent in any defined population in this country. This also
serves as an important cancer epidemiological data in this region during the period of study.