South Sudan must establish a histopathology laboratory
Histopathology is an important branch in laboratory medicine and vital in the management of patients with conditions ranging from tumours, infections, metabolic conditions, and congenital anomalies.
In South Sudan, a histopathology service is emerging. It started in 2012 by sending paraffin tissue blocks to neighbouring countries for processing. Through the efforts of two consultants in Juba this service has been extended across the country by involving the teaching and state hospitals. By this editorial I aim to enlighten clinicians and patients about the importance of histopathology services in diagnosis and management of diseases, and to encourage the government to establish a national histopathology laboratory.
Histopathology services enable the following:
- Typing of tumours (benign vs. malignant /cancer, and carcinoma vs. sarcomas). This has important implications for the management and treatment of patients and their prognosis. It is also possible to tell whether a tumour is primary or secondary. This information is required by clinicians before and after surgery.
- Grading of tumours (low grade vs. high grade, or well differentiated vs. moderately differentiated vs. poorly differentiated / anaplastic). Again, this guides the treatment with prognostic significance.
- Histological staging of tumours aids the refinement of clinical staging. This determines the type and extent of treatment to be offered and also carries prognostic significance.
- Establishment of a national tissue bank (cancer and other diseases) consisting of formalin fixed and paraffin embedded tissue blocks will be in place for future reference and research. This will be of great use to local researchers and those from the other countries. Findings from these researches may be important in planning and policy formulation for the country.
- Screening for some common cancers (e.g. of the cervix, breast, thyroid and prostate) ensuring early detection and improving prognosis.
- Complete autopsies (post-mortems) will be assured as the gross findings will be married with the histopathological findings from tissues sampled. The precision of the causes of death will be improved. This information is vital in setting up a national “cause of mortality” register. It is also important in planning and formulation of policies (related to some diseases) for the country.
- Improved teaching of pathology to medical cadres at all levels. The students will be able to correlate the gross and histopathological appearance of different diseases and therefore come up with a better understanding of disease mechanisms. This will improve the quality of training.
- A national cancer registry with more precise information will be readily available. This information will be paramount in planning and policy making with regards to cancers and their treatment.
Importantly, the setting up of a modern histopathology and cytology department, together with a national Cancer Registry centre at the national level, will have a significant diagnostic and service management value.