Telepathological evaluation of paediatric histological specimens in support of a hospital in Tanzania

Afr Health Sci. 2020 Sep;20(3):1313-1321. doi: 10.4314/ahs.v20i3.37.

Abstract

Background/objective: In a project of telepathology (TP) between German pathologists and a hospital in Tanzania, trained technical assistants have uploaded digital histological images onto the internet-based platform ipath. The diagnoses from 486 paediatric specimens were analysed.

Methods: The investigation included diagnoses, either primarily done via TP or secondarily after a further workup of the paraffin-embedded tissue, which was sent to Germany for cases which could not be solved via TP. In the latter, the initial TP-diagnoses were compared with the results after re-evaluation.

Results: The median age was 11 years. The cohort comprised 390 benign diseases (80.2%) and 96 malignant diseases (19.8%). For benign diseases, the most frequent anatomic sites were lymph nodes, skin, and soft tissue, breast, and head&-neck. Frequent diagnoses were non-specific inflammations and benign tumors. In malignant diseases, the most sites were lymph nodes, skin, soft tissue, head&neck, and ovary and the most frequent diseases sarcomas and lymphomas. The paraffin embedded tissue of 179 cases (36.3%) was shipped to Germany. With the concordance analysis, we could discover the mandatory necessity for the possibility of second opinion in difficult cases.

Conclusion: An exclusively TP-support cannot meet all requirements of modern medical diagnostics. The education of local pathologists is imperative.

Keywords: Telepathology; ipath; low income country; paediatric.

MeSH terms

  • Adolescent
  • Child
  • Child, Preschool
  • Female
  • Hospitals
  • Humans
  • Neoplasms / pathology*
  • Tanzania
  • Telepathology / methods*