In sub-Saharan Africa (SSA), Kaposi's sarcoma (KS) is the most common HIV-associated cancer in men and second most common in women. A large proportion of KS in Uganda is diagnosed in late stage of disease. Hence, promoting early diagnosis of KS is one of the most clinically impactful interventions that could be developed, within the field of HIV-associated cancer. Education of facility-based providers is necessary but not sufficient. Accordingly, the aims of the Uganda-UCSF Consortium Research Project 1 are to:
Aim 1. Develop communication strategies for raising public awareness about KS. With participatory methods, the Consortium will develop several forms of media including fotonovela/comics, radio drama, and short educational films, to raise public awareness of the importance of KS and to promote care seeking for suspected KS. The Consortium will evaluate whether exposure to these media lead to improved KS-related knowledge in a general population sample.
Aim 2. Develop a feasible strategy for training VHTMs regarding KS Identification and referral. The Consortium will adapt an established train-the-trainer strategy for helping VHTMs learn about KS, and how to communicate to community members about KS, its symptoms, techniques for self-screening, and the benefits of early diagnosis and treatment. The Consortium will assess the feasibility and acceptability as well as the effects of the training on VHTM knowledge prior to and after training as well as the retention of KS-related knowledge overtime.
Aim 3. Develop a process for rapid case ascertainment (RCA) of KS as it is diagnosed in the community. The Consortium will develop a system to enable health care facilities in reporting suspected cases of KS to a central team which then rapidly, interviews and clinically assesses the affected patients. This system will provide the requisite platform for understanding current community-based epidemiology of KS in Uganda and for determining the impact of future interventions for promoting early detection of KS. At the end of the funding period, the Consortium will have developed and assessed all of the individual components necessary for the subsequent implementation of a multi-faceted intervention to promote early diagnosis of KS. The ultimate impact of this work will be to promote early detection of KS and improve

Public Health Relevance

KS is the most common malignancy in sub-Saharan Africa and survival after KS diagnosis in Africa is poor. Much of the poor survival stems from late stage diagnosis of KS. Hence, early diagnosis is a realistic means of achieving a major public health impact. The work from this project will promote early detection of KS and impact survival for people with KS.

National Institute of Health (NIH)
National Cancer Institute (NCI)
Specialized Center--Cooperative Agreements (U54)
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Special Emphasis Panel (ZCA1-RPRB-O (M2))
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Dominguez, Geraldina
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University of California San Francisco
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