May Abdel-Wahab, Presenter: Nothing to Disclose

Eduardo Rosenblatt, Abstract Co-Author: Nothing to Disclose

Deborah Van Der Merwe, Abstract Co-Author: Nothing to Disclose

Yaroslav Pynda, Abstract Co-Author: Nothing to Disclose

Joanna Izewska, Abstract Co-Author: Nothing to Disclose

Ahmed Meghzifene, Abstract Co-Author: Nothing to Disclose

Purpose/Objective(s):The scarcity of radiation oncology resources in Africa is becoming more critical with the increase in cancer incidence. A longitudinal assessment of the status of radiation oncology resources in the region over the last 12 years was done to determine the impact of International Atomic Energy Agency(IAEA) programs designed to enhance radiation services in the region.Materials/Methods: Radiation Oncology departments in Africa were surveyed through DIRAC (Directory of Radiotherapy Centers) and this information was supplemented by that available from IAEA Regional African and IAEA Interregional project reports for 2010. The number of megavoltage machines as well as the number of machines per million population were determined and compared with the 1998 levels. Brachytherapy services were also assessed.Results: Of 52 countries in Africa, 24 are known to have teletherapy. However, the distribution of these facilities is still concentrated in the southern and northern states of the continent. The 276 operating megavoltage machines (compared with 155 in 1998) represent an over 76% increase over the past 12 years. Angola, Botswana, Mauritania, Senegal and Zambia developed new radiation therapy capabilities where there were none in 1998. Furthermore there has been an increase in the number of existing teletherapy machines in eighteen African countries, especially in South Africa, Egypt and Morocco. Four countries lost their radiotherapy capability when their previously functioning Co60 unit's source was not replaced. The number of megavoltage machines per million population ranges from 0.015 to 2.35. Brachytherapy resources (HDR or LDR) were only available in 20 out of 52 African countries. The largest brachytherapy services were in Algeria, Morocco, South Africa and Egypt. Decreases in radiotherapy machines per million were due to a decrease of machines in 3 countries (Uganda, Gabon and Zimbabwe) or an increase in population with no change in number of machines. In addition, some countries are in the process of setting-up their first radiation therapy centers such as Niger, Mali, Eritrea, Malawi, Cote D’Ivoire.Conclusions:Progress has been made in initiating radiation oncology services in some countries. However, a large backlog still exists for basic radiation services and much work is needed to keep pace with the burgeoning population of many countries.Radiation Therapy Resources in African CountriesCountries with major resources LINACS2010LINACS1998COBALT2010COBALT1998Tele-therapyTotal2010Tele-therapyTotal1998LDRHDRBrach-therapy Total2010South Africa7824816864001111Egypt542822257653167Morocco231452762810Algeria112910201213114Tunisia61107168415Nigeria504494325Libya114354213Sudan214263112Countries with 1-4 teletherapy machines: (1 machine) Angola, Botswana, Senegal, Madagascar, Namibia, Democratic Republic of Congo, Mauritania, Uganda (2 machines) Ethiopia, Ghana (3 machines) Tanzania, Zambia, Zimbabwe, Mauritius, Cameroon. (4 machines) Kenya. Countries that no longer have teletherapy at the time of the most recent update: Gabon, Liberia, Mozambique,Republic of Congo. Countries that continue to be without access to teletherapy or brachytherapy: Benin, Burkina Faso, Burundi, Cape Verde, Central African Republic, Chad, Cote D'Ivoire, Djibouti, Equatorial Guinea, Eritrea, Gabon, Gambia, Guinea, Guinea-Bissau, Liberia, Mali, Mozambique, Niger, Rwanda, Republic of Congo, Seychelles, Sierra Leone, Somalia, Togo, Lesotho, Malawi, Swaziland. Countries that have teletherapy but are without brachytherapy services: Senegal, Botswana, Democratic Republic of the Congo, Angola.

Abdel-Wahab, M, Rosenblatt, E, Van Der Merwe, D, Pynda, Y, Izewska, J, Meghzifene, A, Changes in the Availability of Radiation Oncology Services in Africa: A Report from the International Atomic Energy Agency.  Radiological Society of North America 2011 Scientific Assembly and Annual Meeting, November 26 - December 2, 2011 ,Chicago IL. http://archive.rsna.org/2011/11030300.html