title: Remote and rapid pathological diagnosis in a resource challenged unit.
abstract: Malawi is one of the world's poorest countries, but despite this, has a dedicated paediatric oncology service. The service has been hampered by the inability to make a timely cytological diagnosis in the majority of patients. A telemedicine programme was commenced to help overcome this problem, and the results for the first 197 consecutive patients are described. The results are compared with the local reports where available. Most samples were fine needle aspirates (104/197-53%), but others included bone marrow aspirates, peripheral blood films and other fluid collections. A diagnosis was arrived at in 52% of the samples; there were 46 discordant results, 38 were when one or other of the local or distant teams were unable to make a diagnosis, and only 8 where the diagnoses of the 2 teams differed. Diagnoses were made and reports were compiled by the 'distant' team within 24 h and sent to the centre in Malawi. This simple telepathology initiative has had a positive impact on clinical management, and could be used in other less resourced centres twinned with better resourced ones.
authors.affiliation: Department of Haematology, Great North Childrens Hospital, Newcastle upon Tyne, UK.
authors.forename: P
authors.initials: P
authors.lastname: Carey
authors.affiliation: Department of Paediatrics, Queen Elizabeth Hospital, Blantyre, Malawi.
authors.forename: R
authors.initials: R
authors.lastname: Fudzulani
authors.affiliation: Medical School, University of Birmingham, Birmingham, UK.
authors.forename: D
authors.initials: D
authors.lastname: Scholfield
authors.affiliation: Department of Paediatrics, Queen Elizabeth Hospital, Blantyre, Malawi.
authors.forename: G
authors.initials: G
authors.lastname: Chagaluka
authors.affiliation: Department of Pathology, Queen Elizabeth Hospital, Blantyre, Malawi.
authors.forename: T
authors.initials: T
authors.lastname: Tomoka
authors.affiliation: Department of Pathology, Queen Elizabeth Hospital, Blantyre, Malawi.
authors.forename: G
authors.initials: G
authors.lastname: Liombe
authors.affiliation: Department of Paediatrics, Queen Elizabeth Hospital, Blantyre, Malawi.
authors.forename: K
authors.initials: K
authors.lastname: Banda
authors.affiliation: Department of Pathology, Great North Childrens Hospital, Newcastle upon Tyne, UK.
authors.forename: V
authors.initials: V
authors.lastname: Wadehra
authors.affiliation: Department of Haematology, Great North Childrens Hospital, Newcastle upon Tyne, UK.
authors.forename: S
authors.initials: S
authors.lastname: Samarasinghe
authors.affiliation: Department of Paediatrics, Queen Elizabeth Hospital, Blantyre, Malawi.
authors.forename: E M
authors.initials: EM
authors.lastname: Molyneux
authors.affiliation: Department of Child Health, Great North Childrens Hospital, Newcastle upon Tyne, UK.
authors.forename: S
authors.initials: S
authors.lastname: Bailey
mesh_terms: D000293:Adolescent; D044963:Biopsy, Fine-Needle; D001856:Bone Marrow Examination; D002648:Child; D002675:Child, Preschool; D003906:Developing Countries / Q000191:economics; D005260:Female; D017048:Health Care Costs; D006295:Health Resources; D006297:Health Services Accessibility; D006801:Humans; D007223:Infant; D008295:Malawi; D008297:Male; D008495:Medical Oncology / Q000191:economics / Q000379:methods*; D010338:Pathology, Clinical / Q000191:economics / Q000379:methods*; D010372:Pediatrics / Q000191:economics / Q000379:methods*; D011237:Predictive Value of Tests; D015397:Program Evaluation; D019113:Telepathology / Q000191:economics; D013997:Time Factors
keywords: Haemato-Oncology; Histopathology; Paediatric Haematology