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Pitfalls of practicing cancer epidemiology in resource-limited settings: the case of survival and loss to follow-up after a diagnosis of Kaposi’s sarcoma in five countries across sub-Saharan Africa

Overview of attention for article published in BMC Cancer, February 2016
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Title
Pitfalls of practicing cancer epidemiology in resource-limited settings: the case of survival and loss to follow-up after a diagnosis of Kaposi’s sarcoma in five countries across sub-Saharan Africa
Published in
BMC Cancer, February 2016
DOI 10.1186/s12885-016-2080-0
Pubmed ID
Authors

Esther Freeman, Aggrey Semeere, Megan Wenger, Mwebesa Bwana, F. Chite Asirwa, Naftali Busakhala, Emmanuel Oga, Elima Jedy-Agba, Vivian Kwaghe, Kenneth Iregbu, Antoine Jaquet, Francois Dabis, Habakkuk Azinyui Yumo, Jean Claude Dusingize, David Bangsberg, Kathryn Anastos, Sam Phiri, Julia Bohlius, Matthias Egger, Constantin Yiannoutsos, Kara Wools-Kaloustian, Jeffrey Martin

Abstract

Survival after diagnosis is a fundamental concern in cancer epidemiology. In resource-rich settings, ambient clinical databases, municipal data and cancer registries make survival estimation in real-world populations relatively straightforward. In resource-poor settings, given the deficiencies in a variety of health-related data systems, it is less clear how well we can determine cancer survival from ambient data. We addressed this issue in sub-Saharan Africa for Kaposi's sarcoma (KS), a cancer for which incidence has exploded with the HIV epidemic but for which survival in the region may be changing with the recent advent of antiretroviral therapy (ART). From 33 primary care HIV Clinics in Kenya, Uganda, Malawi, Nigeria and Cameroon participating in the International Epidemiologic Databases to Evaluate AIDS (IeDEA) Consortia in 2009-2012, we identified 1328 adults with newly diagnosed KS. Patients were evaluated from KS diagnosis until death, transfer to another facility or database closure. Nominally, 22 % of patients were estimated to be dead by 2 years, but this estimate was clouded by 45 % cumulative lost to follow-up with unknown vital status by 2 years. After adjustment for site and CD4 count, age <30 years and male sex were independently associated with becoming lost. In this community-based sample of patients diagnosed with KS in sub-Saharan Africa, almost half became lost to follow-up by 2 years. This precluded accurate estimation of survival. Until we either generally strengthen data systems or implement cancer-specific enhancements (e.g., tracking of the lost) in the region, insights from cancer epidemiology will be limited.

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The data shown below were collected from the profiles of 2 X users who shared this research output. Click here to find out more about how the information was compiled.
Mendeley readers

Mendeley readers

The data shown below were compiled from readership statistics for 109 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
United States 1 <1%
Malawi 1 <1%
Unknown 107 98%

Demographic breakdown

Readers by professional status Count As %
Researcher 26 24%
Student > Master 16 15%
Student > Ph. D. Student 13 12%
Other 9 8%
Student > Doctoral Student 7 6%
Other 17 16%
Unknown 21 19%
Readers by discipline Count As %
Medicine and Dentistry 37 34%
Nursing and Health Professions 20 18%
Social Sciences 7 6%
Biochemistry, Genetics and Molecular Biology 6 6%
Agricultural and Biological Sciences 5 5%
Other 6 6%
Unknown 28 26%
Attention Score in Context

Attention Score in Context

This research output has an Altmetric Attention Score of 2. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 08 August 2020.
All research outputs
#13,761,985
of 22,844,985 outputs
Outputs from BMC Cancer
#3,138
of 8,313 outputs
Outputs of similar age
#198,082
of 397,355 outputs
Outputs of similar age from BMC Cancer
#65
of 195 outputs
Altmetric has tracked 22,844,985 research outputs across all sources so far. This one is in the 38th percentile – i.e., 38% of other outputs scored the same or lower than it.
So far Altmetric has tracked 8,313 research outputs from this source. They receive a mean Attention Score of 4.3. This one has gotten more attention than average, scoring higher than 61% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 397,355 tracked outputs that were published within six weeks on either side of this one in any source. This one is in the 49th percentile – i.e., 49% of its contemporaries scored the same or lower than it.
We're also able to compare this research output to 195 others from the same source and published within six weeks on either side of this one. This one has gotten more attention than average, scoring higher than 66% of its contemporaries.