Resume of the activities carried out in 2017 by the Akbaraly Foundation in its health centers of Mahajanga (“Candide Hospital”) and Fianarantsoa (“Rex”) as well as the peripheral centers (Mahasoa, Sakalalina, Ampasimanjeva, Andonaka and Penitentiary) and with the help of the Mobile Unit.
In 2017 we have carried out 6901 Pap tests in our health centers.
This number almost doubles last year’s result, which clearly reflects the hard work and the determination of all our staff and volunteers. We are very proud to share this wonderful result with you all!
The rate of positive test results is still elevated (14%) with a high level of epithelial lesions and other organic alterations, as you can see in the diagram.
In the cases that required further scrutiny, our patients underwent colposcopy thanks to our state of the art cytology lab, the only one of its kind in Madagascar. We carried out 328 colposcopies, two thirds of which confirmed the presence of a disease: the most common are uterine metaplasia and hyperplasia, followed by cervicitis, tuberculosis, HPV, genital warts, precancerous lesions and carcinomas.
The test results confirmed over 50 cases of cancer, in addition to 16 precancerous lesions and 3 cases of suspect carcinoma.
The patients diagnosed with cancer can undergo LEEP (8 procedures in 2017) or referred to public hospitals for treatment with chemotherapy or surgery – unfortunately only a few them have the economic means to do so.
In the context of our breast cancer prevention program, we have carried out 6647 breast exams in 2017. This is almost triple last year’s result – another important achievement that we are proud to share with you all. In 455 cases, patients also got a mammogram; 60 patients underwent a biopsy for further scrutiny.
The most common issues are nodules and calcifications, but we also diagnosed 50 cases of cancer and 22 suspect carcinomas.
Our healthcare activities dedicated to women also included 9257 consultations and 1132 ultrasounds. We also took care of 2495 pregnant women and delivered 255 babies at our Mahajanga health center.
The average age of our patients is between 30 and 50: this age group is undoubtedly the most numerous, equal to 63% of the total, followed by women between 26 and 30, who represent 10% of the total; the youngest patients (under 25) make up 9% of the total, followed by older women aged 50 to 55 (8%).
In 2017 we have completed 3924 kinesiology sessions, 378 orthopaedic visits and 64 orthopaedic surgeries to correct problems related to malnutrition such as deformed feet and limbs.
We administered vaccines to 68 patients, and guaranteed proper nutrition to 576 malnourished children. Our paediatricians took care of 82 patients.
Resume of the activities carried out in 2016 by the Akbaraly Foundation in its health centers of Mahajanga (“Candide Hospital”) and Fianarantsoa (“Rex”) as well as the peripheral centers (Mahasoa, Sakalalina, Ampasimanjeva, Andonaka and Penitentiary) and with the help of the Mobile Unit “Luisa”.
Regarding the “gynecological program” which, together with the one dedicated to breast cancer, makes up our “Pink and Turquoise Program for Women”, this year we carried out 3078 Pap tests, mostly for new patients (70% of the total).
Out of all the tests, 72.5% were negative, while 14.5% were positive for several abnormalities. In 7.8% of the cases, the sample was insufficient for proper analysis, and 5.4% of the tests are still waiting to be analysed.
In the cases that required further scrutiny, the patients underwent a colposcopy (more than 300 in 2016); we also did 110 anatomic pathology tests. Out of the overall results, 66% were positive and showed evidence of some abnormality.
Most of the abnormalities registered were precancerous lesions (a third of the total), while cancer (adenocarcinomas and carcinomas) was present in 17% of cases.
The patients who suffer from cancer are treated with diathermic resection and conisation; only a few of them have enough means to go to a public hospital in order to undergo surgery or receive chemotherapy and radiotherapy treatments.
When it comes to the “breast program”, in 2016 we performed 2638 breast exams, most of which were normal (around 65%).
Among the cases that needed further tests, 10% showed the presence of cancer, while 56% showed only a benign condition.
We also did 542 breast ultrasounds and more than 300 mammograms, in addition to 36 biopsies.
BREAST PROGRAM RESULTS:
The patients treated in our centers are mostly over 30 years old (33% of the total are between the ages of 34 and 44), followed by over-45 women (28%) and young women between the ages of 24 and 34 (21%).
Teens and younger women (under 24) make up a smaller percentage (about 6%) while over-55 ladies represent 9.8% of the total. Finally, only 2.5% of our patients are older ladies over the age of 65.
Half of them come to our centers thanks to a referral from their general family doctor, while another 50% come voluntarily after getting to know our activities through our awareness campaigns.
Overall, the media campaigns (radio, TV and text messages) managed to convince over a third of our patients to come to our centers for a screening, but the awareness-raising campaigns on the territory, especially the ones who involve medical personnel, and the “word of mouth” are still relevant: 14% cited the Foundation’s reputation as the main reason for their visit.
MISSIONS FEATURING THE MOBILE UNIT “LUISA”
The awareness campaigns in the countryside, which numbered 47 in 2016, reached more than 6100 people and sparked a lot of interest.
During these missions we performed over 750 Pap tests and over 1100 breast exams as well as administering 294 HPV vaccines for girls under the age of 13.
In addition to the activities that make up the cancer prevention program, in the obstetrics and gynecological department we performed more than 5600 general consultations, more than 1400 ultrasounds and over 1500 pre-natal consultations.
224 women had their babies in our Mahajanga center this past year, while 63 were referred to the public health centers for a C-section. The mortality rate for newborns was 0.8%, with only two deaths, while maternal mortality was at 0.
Our centers also offer paediatric consultations for children (with more than 200 little patients this year) and nutritional consultations, which help parents take care of the correct nutrition for their children up to the age of 5 (127 patients in 2016). The cases of severe malnutrition make up 22% of the total, while moderate cases total 23.5%.
Vaccines are another important component of our activities: in 2016, we administered 975 doses to 500 patients, including the following vaccines: rotavirus, polio, pneumococcal conjugate, DTP (diphtheria-tetanus-pertussis), tetanus and HPV; we started offering the latter at the beginning of 2016 and it already makes up 32.6% of the total.