Cytology Society of Uganda (CSU)

A PROPOSAL TO ESTABLISH BASIC CYTOLOGY, HISTOLOGY

LABORATORY AND TELEPATHOLOGY SERVICES IN UGANDA’S REGIONAL
REFERRAL HOSPITALS

SUBMITTED TO: PREPARED BY:

Permanent Secretary Mwesigwa Boaz
Ministry of Health mwesigwaboaz155@gmail.com
P.O.Box 7272 Tel:+256705482996
Kampala, Uganda
Table Of Contents

List Of Tables...............................................................................................................3
List Of Figures .............................................................................................................3
List Of Acronyms .........................................................................................................4
1.0 Project Information .............................................................................................5
1.1 Executive Summary: ..........................................................................................6
1.2 Project Background: ...........................................................................................6
1.3 Project Problem Statement: ................................................................................7
1.4 Project Objectives: ..............................................................................................8
1.41 Project Main Ojective ...................................................................................8
1.42 Project Specific Ojectives ..............................................................................8
1.5 Project Justification: ..........................................................................................8
1.6 Project Expected Outcomes ................................................................................8
1.7 Scope Pathology Services:...................................................................................8
1.71 Cytology Services .........................................................................................9
1.72 Histology Services ........................................................................................9
1.73 Telepathology Services ...............................................................................10
1.74 Proposed pathology laboratory services layout & work flow ........................ 11
1.8 Proposed Locations: ......................................................................................... 12
1.9 Project Duration: .............................................................................................. 12
1.10 Proposed Budget And Allocation Plan ............................................................ 12
2.0 Project Implemention & Managemenet Plan......................................................16
2.1 Monitoring And Evaluation Plan: ......................................................................16
2.2 Project Sustainability Plan ...............................................................................17
References .................................................................................................................18
Annexes .....................................................................................................................19
Annex I: Csu Registration Certificates.....................................................................19
Annex Ii: Organisation Leadership In Csu............................................................... 20
Annex Iii: Sample Gynecological Cytology Services Request Form ........................... 21
Annex Iv: Sample Non-Gynecological Cytology Services Request Form ....................22
Annex V: Sample Histology Services Request Form .................................................23

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LIST OF TABLES
Table 1: The most frequent cases of cancer in different sexes globally as compared to
Africa.7
Table 2: Proposed test list under the cytology section ……………..………………………..9
Table 3: Proposed budget for Histology laboratory services……………………………12-13
Table 4: Proposed budget for Cytology laboratory services……………………………14-15
Table 5: Proposed budget for Telepathology services………………………………………..15
Table 6: Budget allocation plan………………………………………………………………….15
Table 7: Shows the human resource personnel required for project implementation16
Table 8: Proposed anatomical pathology services testing fees……………………………..17

LIST OF FIGURES
Figure 1: Shows the proposed pathology services………………………………8
Figure 2: Shows the proposed arrangement of a static telepathology system…………10

Figure 3: Shows the proposed layout for a basic anatomical pathology laboratory……11

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LIST OF ACRONYMS

CPD Continuous Professional Development

CSU Cytology Society of Uganda

CT Computed Tomography

FNAC Fine Needle Aspiration Cytology

GLOBOCAN Global Cancer Observatory

H&E Hematoxylin and Eosin

HPV Human papillomavirus

IAC International Academy of Cytology

IARC International Agency Research on Cancer

MOH Ministry of Health

NCD Non communicable diseases

RRH Regional referral hospital

UCI Uganda Cancer Institute

UNHLS Uganda National Health Laboratory Services

URSB Uganda Registration Services Bureau

US Ultrasound

WHO World health organization

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 1.0 PROJECT INFORMATION

1.a Project title Establishment of basic cytology, histology laboratory and

telepathology services at Uganda’s Regional referral hospitals
1.b Project main To the lower the burden of disease associated with cancer and
objective other cancer-related conditions by establishing sustainable
pathology services for early screening and diagnosis.
1.c Project There shall be an improvement in the quality of life and the
expected economic productivity of our Ugandan people
outcomes
1.d Proposed Cytology, Histology & digital (telepathology) services
services
category
1.e Proposed Lira RRH, Gulu RRH, Masaka RRH, Mbale RRH, Jinja RRH,
location(s) Mbarara RRH, Arua RRH, Soroti RRH, Naguru RRH,
1.f Supporting Ministry of Health (MOH)
agency
1.g Implementation Cytology Society of Uganda (CSU)
agency URSB Reg no: 80020002492775
csu256uganda@gmail.com
1.h Project 1year (2020-2021)
duration
1.i Amount 824,449,600 Uganda shillings (216,960USD)
requested
1.k Contact person Mwesigwa Boaz
mwesigwaboaz155@gmail.com
Tel:+256705482996

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1.1 EXECUTIVE SUMMARY:
CSU is a registered scientific, not for profit, national society of professionals who are
involved in research and practice of diagnostic cytology in Uganda, histology, molecular
diagnostics among other disciplines. Its membership is comprised of mainly physicians
(cytopathologists) and cytotechnologists who are all involved in the management of
pathology screening & diagnostic services. It is duly registered by the Uganda
registration services bureau (URSB) and incorporated under the laws of Uganda
(Registration certificate no: 80020002492775). The mission of CSU is to promote and
maintain high standards of care through cancer screening and excellence in cancer
diagnostics in Uganda and beyond.

CSU has been involved in a number of activities such as: - using radio & social media
to sensitize the public on cancer /infectious disease, encouraging need for early cancer
screening and diagnosis, provision of CPD courses/modules to other scientists among
others. This project proposal by CSU therefore seeks for financial assistance and
approval from the ministry of health to us establish cytology, histology, & telepathology
services in the 8 selected regional referral hospitals of Uganda which shall include Lira
RRH, Arua RRH, Gulu RRH, Mbale RRH, Masaka RRH, Soroti RRH, Naguru RRH and
Jinja RRH for purposes of early cancer detection and other cancer related-diseases.

1.2 PROJECT BACKGROUND:

Cancer is characterized by uncontrolled growth and proliferation of abnormal cells
resulting from internal and external risk factors working together and/or in sequence
to trigger the process. People may be exposed to risk factors or cancer-causing agents
in their environment and/or from their lifestyles. These cancer-causing agents play a
larger role in the aetiology of cancer than inherited genetic factors. Cancer risk factors
are highest in groups with the least education and lowest social status; these same
groups also have poorer survival rates than higher socio-economic status groups [1].
Studies have also shown that 13% of overall cancer diagnoses are attributable to
infectious agents such as;-helicobacter pylori, high-risk human papillomavirus (HPV),
Epstein-Barr virus (EBV), hepatitis B virus (HBV), hepatitis C virus (HCV), human
herpesvirus 8 (HHV-8), human T-cell lymphotrophic virus, schistosoma haematobium
among others[2].

In 2018, 18.1 million people around the world had cancer, and 9.6 million died from
this disease. It is also estimated that by 2040, these figures will nearly double, with a
greatest increase projected to occur in the low & middle income countries. In these
countries resources available for prevention, diagnosis and treatment of cancer are
limited or nonexistent. Globally, the most frequent cancers among males are cancers of
the lung, prostate, colorectum & stomach, while among women these are cancers of the
breast, colorectum, lung and cervix. In Africa, most frequent ones are prostate, liver and
colorectum while among women these are breast, cervix and colorectum [3],[4].

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Table 1: The most frequent cases of cancer in different sexes globally as compared to
Africa
Men Global Africa Women Global Africa
Lung 1 4 Breast 1 1
Prostate 2 1 Colorectum 2 3
Colorectum 3 3 Lung 3 8
Stomach 4 5 Cervix 4 2

In Uganda, 32,617 were diagnosed of cancer in 2018 and about 21,829 died from this
disease. The leading cancers in women were cervical, breast, Kaposi sarcoma and Non-
Hodgkin lymphoma whereas in men, Kaposi sarcoma, prostate oesophagus and liver
were the most common cancers [5]. The good news is that cancer is one of the most
preventable non-communicable chronic diseases. More than 30% of cancer deaths can
be prevented and with adequate investments in prevention and control strategies, the
morbidity and mortality rates attributable to cancers can be significantly reduced. An
investment into the pathology services shall provide opportunities for early cancer
detection (through early screening and diagnosis) hence lowering the incidence rates
and an improvement on the overall patient outcome.

1.3 PROJECT PROBLEM STATEMENT:

Cancer is the second leading cause of death globally and was responsible for 9.6million
deaths in 2018. Globally 1 in 6 deaths is due to cancer and approximately 70% of these
occur in low- and middle-income countries. Late-stage presentation and inaccessible
diagnosis and treatment are common. In 2018, only 26% of low-income countries
reported having pathology services generally available in their public health sector [6].

Cancer results in economic burden for patients, healthcare systems and countries due
to healthcare spending, and productivity loses from morbidity and premature mortality.
The global economic burden of cancer is unknown, although data is available in a few
countries. In 2017, the estimated cancer healthcare spending in the United States was
US$161.2 billion; productivity loss from morbidity, US$30.3 billion; and premature
mortality, US$150.7billion. The economic burden of cancer was approximately 1.8% of
gross domestic product (GDP). In the European Union, healthcare spending was €57.3
billion, and productivity losses due to morbidity and premature deaths were €10.6billion
and €47.9 billion, respectively. With informal care costs of €26.1billion, total burden
rose to €141.8billion, 1.07% of GDP [7].

In Uganda, majority of our regional referral hospitals lack the basic cytology or histology
services thus offering patients with no available opportunities for the early detection of
cancer and other cancer-related diseases. Reports from Uganda Cancer Institute (UCI)
indicates that for every 100 cancer new cases diagnosed, 80% of them die due to
advanced stage disease that is too difficult to treat[8]. This therefore calls for an urgent
need to invest in and establish cytology & histology laboratory services for screening
and diagnosis of cancer & other cancer-related diseases right from the regional reference
level.

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 1.4 PROJECT OBJECTIVES:
1.41 PROJECT MAIN OJECTIVE
To the lower the burden of disease associated with cancer and other cancer-related
conditions by establishing sustainable pathology services for early screening and
diagnosis.

1.42 PROJECT SPECIFIC OJECTIVES

1. To lower the incidence and mortality associated with cancers and other cancer-
related conditions through enhancing early detection.
2. To improve on turnaround times and timely reporting by decentralizing cytology,
histology laboratory and telepathology services to the regional referral hospitals.
3. To reduce on the referral of samples or patients abroad by carrying out all
specialized pathological tests locally.
4. To increase accessibility and affordability of cytology & histology services to our
Uganda people.

1.5 PROJECT JUSTIFICATION:

The proposed pathology services once established shall aid the early detection of cancer
(through screening and diagnosis), cancer surveillance, and cancer registration. These
services shall also support diagnosis of other conditions such as infectious disease,
inflammatory disease and degenerative disease.

1.6 PROJECT EXPECTED OUTCOMES

There shall be an improvement in the quality of life and the economic productivity of
our Ugandan people.

1.7 SCOPE PATHOLOGY SERVICES:

These shall include cytology, histology and telepathology (digital telemicroscopy)

PATHOLOGY SERVICES

CYTOLOGY HISTOLOGY TELEPATHOLOGY

Basic H&E

Gynecological cytology

Non-gynecological cytology

Figure 1: Shows proposed pathology services

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 1.71 CYTOLOGY SERVICES
This section of cytology shall collaborate and provide diagnostic opinions to various
hospital departments such as gynecology, nursing, midwifery, internal medicine,
surgery, bronchoscopy, endoscopy, radiology, gastroenterology, hematology, dentistry
and ophthalmology. Samples obtained from these departments will be processed,
examined and analyzed by a cytotechnologist. The cytotechnologists shall also provide
assistance to physicians/clinician in the technical aspects of specimen collection, slide-
preparations and on-site assessment of specimen adequacy. A completely filled request
form for gyn or non-gyn cytology shall be submitted to the cytology section as shown in
annexes 1 & 2. The proposed tests to be conducted are as shown in the table below.

Table 2: Proposed test list under the cytology section

Gynecological cytology services
Category 1: Conventional cytology
 Cervical cytology (Pap smear test)
 Vaginal cytology
 Endometrial cytology
Category 2: Molecular cytology
 High-risk HPV DNA or RNA Testing
 Nucleic acid amplification test
(NAAT) for Chlamydia trachomatis
& Neisseria gonorrhea
Non-gynecological cytology services
Category 1: Exfoliative cytology
 Nipple discharge cytology
 Urine cytology
 Body fluids cytology
 Respiratory cytology
 Gastrointestinal brush cytology
 Esophageal cytosponge cytology
 Cerebral spinal fluid cytology
 Skin scrape cytology
 Imprint/touch prep cytology
 Impression (ocular) cytology
 Oral/orapharyngeal cytology
 Anal-rectal cytology
 Bone marrow aspiration cytology

Category 2: Fine needle aspiration

cytology (FNAC)
 FNAC -By conventional method
 FNAC-Ultrasound guided
 FNAC-CT guided

1.72 HISTOLOGY SERVICES

The section of histology shall collaborate and provide medical/diagnostic opinions to
various hospital departments such as Surgery, gynecology, dentistry, dermatology,
internal medicine among others. In this section, a cytotechnologist shall perform all
technical procedures such as grossing, tissue processing, sectioning, staining and pre-
screening of histology slides in accordance with the standard operating procedures.
Basic and routine H & E shall be performed on various tissues as received from various
departments and shall be graded separately based on their sizes. A completely filled up
histology request form shall be submitted to laboratory along with the samples as shown
in annex 3.

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 1.73 TELEPATHOLOGY SERVICES
The section of telepathology shall assist in linking and establishing a communication
between an onsite cytotechnologist & a specialized pathologist from a distance. The
onsite cytotechnologist will capture histology images and some difficult cases on
cytology (photomicrographs) which shall later be transmitted via email together scanned
copies of patient’s request form to either a senior cytotechnologist or to a specialized
pathologist for further analysis. In this scenario, a static telemicroscopy system shall be
assembled so as to aid in photomicrography, teleconsultation, quality assurance and
second opinion purposes.

This static telemicroscopy (telepathology) system shall consist of:-

1. 5MP digital eye piece microscope camera
2. Microscope
3. Software
4. Laptop
5. Internet connectivity (Modem or Wi-Fi access)
6. Printer

Figure 2: Shows the proposed arrangement of a static telepathology system

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 1.74 PROPOSED PATHOLOGY LABORATORY SERVICES LAYOUT & WORK
FLOW

Figure 3: Shows the proposed layout for a basic anatomic pathology laboratory

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 1.8 PROPOSED LOCATIONS:
With approval from the ministry of health, the proposed cytology, histology and
telepathology services shall be established at:-
1. Lira Regional referral hospital
2. Gulu regional referral hospital
3. Mbale regional referral hospital
4. Soroti regional referral hospital
5. Masaka regional referral hospital
6. Arua regional referral hospital
7. Jinja regional referral hospital
8. Naguru regional referral hospital

The hospital administration shall assist by identifying & providing free hospital space
to enable establishment of the proposed pathology sections. Each regional referral
hospital shall be required to have at least 2 cytotechnologists for efficient and timely
services.

1.9 PROJECT DURATION:

With sufficient funding and support from the ministry of health project shall to take
place in the period of 1year from 2020-2021.

1.10 PROPOSED BUDGET AND ALLOCATION PLAN

Table 3: Proposed budget for Histology laboratory services

sr item Quantity Estimated Estimated

no amount amount
(UGX) (USD) Rate
@3800
A. EQUIPMENTS
1 YD-315 Rotatory microtome 1pc 19,095,000 5025
YD-6LTissue embedding center with
2 cold plate 1pc 11,400,000 3,000
3 Leica 1210 Rectangular Water bath 1pc 3,550,000 934
4 YD-2900 Tissue processor 1pc 33,820,000 8,900
Tissue-Tek® Manual Slide Staining
5 Set 1pc 2,375,000 625
24-Slide Slide Holder with detachable
6 handle 1pc 543,400 143
SUB TOTAL 70,783,400 18,627
B. REAGENTS, SOLVENTS & CONSUMABLES
1 Mayers Hematoxylin 1ltr 367,300 97
2 Eosin Y 5ltrs 322,500 85
3 70% Alcohol 5ltrs 150,000 39

12
4 Acid alcohol 5ltrs 149,300 39
5 99%Isopropranol 5ltrs 265,000 68
6 95%Alcohol 20ltrs 240,000 63
Formaldehyde solution
7 (formalin)36-38% 5ltrs 50,000 13
8 Hydrochloric acid (Concentrated). 2.5ltrs 100,000 26
9 100% Alcohol 5ltrs 330,000 87
10 Xylene 5ltrs 202,000 53
11 Paraffin wax (paraplast) 1kg 110,000 29
12 DPX Mountant 500ml 130,000 34
13 Microscopic oil immersion 100ml 65,000 17
14 Embedding cassettes 2000/pcs 570,000 150
15 Trimming blade 130mm 50/pak 1,117,200 294
16 Dissecting/grossing board 1pc 570,000 150
17 Coverslips(24×50mm) 1000pc 406,000 107
18 Block filling cabinet 1pc 1,862,500 490
19 Microscope slides-Frosted Ended 50/pak 8,000 2
20 Slide trays-20slides 1pc 180,000 47
21 Slide mailers-2slides 1pc 35,000 9
22 Slide box-100 capacity 1pc 28,000 7
23 Marking pen 12/box 262,400 69
24 Measuring cylinder-100ml 1pc 10,000 3
25 Measuring cylinder-1000ml 1pc 40,000 11
26 Apron vinyl 1pc 20,000 5
27 Face shield 1pc 35,000 9
28 Gaggles 1pc 60,000 16
29 N95 respirators 20pcs 700,000 184
30 Bioharzard Waste bin 1pc 105,000 28
31 Examination gloves latex 100/box 50,000 13
32 Slide staining Jar-glass 12pc 780,000 205
33 Slide staining rack 1pc 120,000 32
34 Metallic base mould (15×15×5mm) 12pc 874,000 230
35 Metallic base mould (24×24×5mm) 12pc 874,000 230
36 Metallic base mould (30×24×5mm) 12pc 874,000 230
37 Metallic base mould (37×24×5mm) 12pc 874,000 230
Tissue forceps,straight,smoothed
38 (140mm) 2pc 15,000 4
Tissue forceps,straight,toothed
39 (140mm) 2pc 15,000 4
40 Low profile microtome blades 50pcs 513,000 135
41 Beaker 250ml plastic 1pc 10,000 3
42 Beaker 500ml plastic 1pc 15,000 4
SUB TOTAL 13,507,700 3,555

GRAND TOTAL 84,291,100 22,182

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Table 4: Proposed budget for Cytology laboratory services

Sr Item Quantity Estinated

No Estimated amount
amount USD
UGX Rate @3800
A. EQUIPMENTS
1 Refrigerator 1pc 500,000 132
2 Centrifuge 1pc 500,000 132
Manual Slide Staining Set-(Gyn
3 cytology) 3pc 195,000 51
Manual Slide Staining Set-(Non gyn
4 cytology) 12pc 780,000 205
SUBTOTAL 1,975,000 520
B.REAGENTS,SOLVENTS AND CONSUMABLES
1 Harris hematoxylin-papanicolaou 2.5ltrs 277,700 73
2 Eosin Azure 50-papanicolaou 5ltrs 322,500 85
3 Orange G6-papanicolaou 5ltrs 322,500 85
4 100% Alcohol 5ltrs 330,000 87
5 95% Alcohol 20ltrs 240,000 63
6 70% Alcohol 5ltrs 150,000 39
7 Methanol 2.5L 120,000 32
8 Methylene blue 1L 55,000 14
9 xylene 5L 197,000 52
10 Acid alcohol 5ltrs 145,500 38
11 Hydrochloric acid (Concentrated) 2.5ltrs 100,000 26
12 Slide staining rack 1pc 120,000 32
13 Cotton wool Big size 5,500 1
14 Endometrial collection kits 35/box 1,500,000 395
15 Pap smear collection kits 25/box 200,000 53
16 ZN staining kit 1kit 200,000 53
17 High Vaginal Swabs (HVS) 100/pack 80,000 21
18 Microscopic oil immersion 500ml 65,000 17
19 Coverslips(24×50mm) 1000/pac 395,700 104
20 Eosin Y 1ltr 314,300 83
21 Microscope slides-Frosted Ended 50/pak 8,000 2
22 Slide trays-20slides 1pc 180,000 47
23 Slide mailers-2slides 1pc 35,000 9
24 Slide box-100 capacity 1pc 28,000 7
25 Marking pen 12/box 262,400 69
26 Measuring cylinder-100ml 1pc 25,000 7
27 Measuring cylinder-1000ml 1pc 65,000 17
28 Apron vinyl 1pc 20,000 5
29 Face shield 1pc 35,000 9
14
30 Gaggles 1pc 60,000 16
31 N95 respirators 20pcs 700,000 184
32 Biohazard Waste bin 1pc 105,000 28
33 Examination gloves latex 100/box 50,000 13
34 Surgical face masks 50pc 90,000 24
35 2ml syringes 100pcs 27,000 7
36 5ml syringes 100pcs 35,000 9
Safety box for syringes & needle
37 disposal 20/pack 40,000 11
SUBTOTAL 6,880,200 1,811

GRAND TOTAL 8,855,200 2,330

Table 5: Proposed budget for Telepathology services

Sr no item Quantity Estimated Estinated amount
amount UGX USD
1 Olympus CX23 microscope 1pc 6,000,000 1,579
2 5MP Digital eye piece camera 1pc 800,000 211
3 HP Color lazer printer 1pc 1,500,000 395
4 Africell 4G LTE Modem 1pc 110,000 29
5 Dell laptop 1pc 1,500,000 395
TOTAL 9,910,000 2,608

Table 6: Budget allocation plan

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 2.0 PROJECT IMPLEMENTION & MANAGEMENET PLAN
For effective management and supervision of these pathology services, we propose the
ministry of health to effect recruitment of the following personnel and to pay them a
monthly salary under the scale proposed below.

Table 7: Shows the human resource personnel required for project implementation.
Sr.no Position No of Posts Allocation Proposed salary scale
1 Senior Cytotechnologist 2 MoH or UNHLS U3
Senior quality assurance officer
3 (cytology services) 1 MoH or UNHLS U3
Senior quality assurance officer
4 (histology services) 1 MoH or UNHLS U3
Cytotechnologists-Entry level
5 graduates 16 RRH U4
Total 20

2.1 MONITORING AND EVALUATION PLAN:

The overall performance of the proposed cytology & histology services shall be monitored
and evaluated right from the pre-analytical phase, analytical phase and at the post-
analytical phase. This shall be done by:-
1. Enrolling the laboratory in an accredited External quality assessment scheme
(EQA) so as to improve on individual’s performance appraisal performance based
on a peer review and to maintain professional standards in reporting.
Telepathology and telemonitoring will be employed to achieve this level of review.
2. Establishing internal and external audit assessments schemes.
3. Enrolling the cytotechnologists into annual continuous professional development
courses (CPD) as a way of keeping an update on their skills.

The senior quality assurance officer in charge of cytology services shall be responsible
for designing, implementing quality assurance schemes and developing of cytology CPD
modules alongside other professional bodies.

The senior quality assurance officer in charge of histology services shall be responsible
for designing quality assurance schemes and developing of histology CPD modules
alongside other professional bodies.

The staff cytotechnologists shall conduct daily internal quality controls such as
equipment maintenance, troubleshooting and maintenance of cytology/histology
register.

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 2.2 PROJECT SUSTAINABILITY PLAN
At the end of 1year after which funding from donors/ministry of health is withdrawn
the pathology laboratory sections shall continue to provide services to the people. For
timely procurement of reagents /consumables and effective running of the pathology
laboratory, the following charges are proposed. The fees collected shall be reflected in
the hospital accounts, audits and accountability reports shall be made available the
ministry.

Table 8: Shows the proposed testing fees

17
REFERENCES
1. World Health Organization/International Agency for Research on Cancer (IARC).
GLOBOCAN 2008
2. de Martel C, Georges D, Bray F, Ferlay J, Clifford GM Global burden of cancer
attributable to infections in 2018: a worldwide incidence analysis. Published:
December 17, 2019
3. World Health Organization/International Agency for Research on Cancer (IARC).
GLOBOCAN 2018. Population fact sheets for Africa
4. WHO report on cancer: setting priorities, investing wisely and providing care for
all. Geneva: World Health Organization; 2020. Licence: CC BY-NC-SA 3.0 IGO.
5. World Health Organization/International Agency for Research on Cancer (IARC).
GLOBOCAN 2020. Population fact sheets for Uganda
6. Guide for establishing a pathology laboratory in the context of cancer control.
Geneva: World Health Organization; 2019. Licence: CC BY-NC- SA 3.0 IGO.
7. https://canceratlas.cancer.org/taking-action/economic-burden. Accessed on
9th/8/2020
8. https://www.independent.co.ug/growing-burden-cancer-uganda. Accessed on
10th/8/2020

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Annexes
Annex I: CSU registration certificates

19
 Annex II: Organisation leadership in CSU

Excecutive committee
Name Position Telephone Email address
1. Mwesigwa Boaz Founder & 0705482996 mwesigwaboaz155@gmail.com
President
2. Abila Derrick Vice president 0758000280 abilabary@yahoo.com
3. Twijukye Norman Secretary 0701230777 norman8tl@gmail.com
General
4. Ssedangira Ibrahim Treasurer 0705483729 ibrahimsseddangira@gmail.com
5. Wanurubu Denis Speaker 0777260138 denniswamurubu@gmail.com
6. Matsiko Joseph Organization 0714385841 jmatsiko@gmail.com
secretary
7. Nkwasibwe Timothy Public relations 0704842991 timodegreat@gmail.com
officer
8. Mirembe Ruth Gender affairs 0780447328 elisamirembe@gmail.com
9. Dr. Othieno Emmanuel Patron-CSU 0772684944 othienoemma@yahoo.com
10. Dr. Daniel Wamala IAC 0752811711 dwamala@gmail.com
representative

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 Annex III: Sample Gynecological cytology services request form
Patients Information
Hospital ID Alternative identifier Date of birth

Surname Given name Telephone

Physical address Billing

Private Insurance
Requesting Physician/Clinician/Practitioner
Name Location/facility/address Telephone

Specimen collection date Time (24hr) Assisted by(Nurse/Mid-wife) if any Copy report to/Department(Email address)

SERVICES/TESTS REQUIRED
CERVICAL CYTOLOGY (PAP) TEST VAGINAL CYTOLOGY TEST ENDOMETRIAL CYTOLOGY TEST

Other tests
High-risk HPV DNA testing
E6/E7 HPV mRNA testing
Chlamydia trachomatis (Nucleic acid amplification test, NAAT)
Neisseria gonorrhea (Nucleic acid amplification test, NAAT)
CLINICAL DETAILS (check all that applies to gyn)
Gravida________________Parity__________________LMP__________________________
Routine Exam Hysterectomy, total Cryo of Cervix
Pregnant Hysterectomy ,subtotal Hormone Replacent therapy
Postpartum Radiation Therapy Oral Contraceptives
Post-Menopausal Chemotherapy DES Exposure
Post Abortion Cervix Conization IUD
Abnormal Bleeding Cryolaser Colposcopy
History of malignancy HPV Vaccination history Other(specify below in the clinical remarks)
CLINICAL REMARKS (Please describe if any)

LABORATORY USE ONLY

CYTOTECHNOLOGIST:
Name:____________________________________________. Signature:____________________________________________

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 Annex IV: Sample Non-gynecological cytology services request form
Patients Information
Hospital ID Sex Date of birth

Surname Given name Telephone

Physical address Billing Private client Insurance Accession number (Lab use only)

Requesting Physician/Clinician/Practitioner
Name Location/facility/address Telephone

Specimen collection date Time(24hr) Copy results to/Department (Email address

Test menu
NON GYN,EXFOLIATIVE CYTOLOGY TEST NON GYN, FINE NEEDLE ASPIRATION CYTOLOGY TEST (FNAC)

Nipple discharge cytology: SPECIMEN COLLECTION TECHNIQUE USED

Left-breast Right-breast FNAC-Conventional method
Urine cytology: FNAC-Ultrasound guidance
Voided Catheterized Urethral washing FNAC-CT guidance
Body fluids:
Pleural Peritoneal Pericardial NEEDLE GAUGE SIZE USED
Synovial Cystic Ocular(vitreous) 21G 22G 23G
Respiratory cytology:
Sputum Bronchial alveolar larvage FNA SPECIMEN COLLECTION SITE
Bronchial brush Bronchial wash Breast
Gastrointestinal brush cytology: Location: Left-breast Right-breast Subareolar
Stomach Duodenum Pancreas Quadrants: Upper outer (UO) Upper inner (UI)
Esophageal cytosponge cytology Left outer (LO) Left inner (LI)
Cerebral spinal fluid cytology Thyroid
Skin scrape cytology Location: Left lobe Right lobe Isthmus
Imprint (touch-prep) cytology Salivary glands
Impression (ocular) cytology Location: Left parotid Right parotid
Oral & oropharyngeal cytology Left submandibular Right submandibular
Anal-rectal cytology Kidneys
Bone marrow aspiration cytology Location: Left kidney Right kidney
Other (specify in clinical remarks Soft tissues Prostate Head & Neck
Mediastinum Other (specify in clinical remarks)

CLINICAL REMARKS (Please describe if any)

_____________________________________________________________________________________________________

laboratory use only

CYTOTECHNOLOGIST

Name:____________________________________________ Signature:___________________________________

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 Annex V: Sample Histology services request form
Patients Information
Hospital ID Sex Date of birth

Surname Given name Telephone

Physical address Billing

Private patient Insurance
Requesting Physician/Clinician/Practitioner
Name Location/facility/address Telephone

Specimen collection date Time(24hr) Copy results to/Department (Email address)

Information on sample submitted

Size of tissue(s) Small Medium Large Large & complex
Fixative used Formalin Glutaraldehyde Alcohol Other
Number of samples____________________ Sample collection site:___________________________

Clinical details
CLINICAL DIAGNOSIS
__________________________________________________________________________________________________________

CLINICAL HISTORY
__________________________________________________________________________________________________________

__________________________________________________________________________________________________________

__________________________________________________________________________________________________________

PREVIOUS HISTOPATHOLOGY/CYTOLOGY RESULT

YES NO

If yes indicate the result:_______________________________________________________________________________________

REASON FOR PATHOLOGY REQUEST

_________________________________________________________________________________________________________

Laboratory use only

GROSS DESCRIPTION
_________________________________________________________________________________________________________

_________________________________________________________________________________________________________

NO OF CASSETTES USED:_____________________________

CYTOTECHNOLOGIST:
Name:____________________________________________. Signature:_____________________________________________

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