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Norris Cotton Cancer Center
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Cancer in Tanzania

Located on the coast of east Africa, Tanzania is a country of 45 million people and is served by just one specialized cancer center: the Ocean Road Cancer Institute (ORCI). As the population grows, the cancer burden is increasing in Tanzania as it is in all low- and middle-income countries.

Diversity in Tanzania

The people of Tanzania come from approximately 125 different ethnic groups, and the resulting genetic diversity is greater than in any other country. This is both a challenge and an opportunity for cancer investigators who are advancing precision medicine, where patients will be matched with drugs targeted to the biology of their particular genetically-driven disease.

Increasing Research Capacity in Tanzania

Our current project in Tanzania, led by principal investigator Scott Williams, PhD with co-investigators Judy Rees, BM, BCh, MPH, PhD, and Tor Tosteson, ScD, is focused on increasing the capacity of Tanzanian oncologists to participate in and lead research projects. With funding from the National Institutes of Health Fogarty International Center we forged a highly successful partnership with Ocean Road Cancer Institute that includes faculty mentors from Dartmouth's Norris Cotton Cancer Center and ORCI. The project, DarDarCan, supported three junior oncologists as trainees in 2013 for the two-year program. Each was matched with an ORCI faculty member and faculty from NCCC to work on a research project from concept through writing for publication.

Trainee Project ORCI Mentor NCCC Mentors
Nazima Dharsee, MD Epidemiological Study Of Human Papilloma Virus Prevalence Among Head And Neck Cancer Patients In Tanzania Twalib Ngoma, MD Jason Pettus, MD
Salum Lidenge, MD Presentation And Risk Factors For Epidemic Kaposi’s Sarcoma
At Ocean Road Cancer Institute
Julius Mwaiselage, MD Kathleen Lyons, ScD
Judy Rees, BM, BCh, MPH, PhD
Mamsau Ngoma, MD Subtype Distribution Of Human Papillomavirus In HIV Positive And Negative Women With Invasive Cervical Cancer In Tanzania Crispin Kahesa, MBBS, MSc.CEB, PhD Jennifer Doherty, PhD

SYNERGY and Our Research Training Program

In June 2014, Drs. Dharsee, Lidenge, and Ngoma began their training with a one-month residency at NCCC. They joined other junior physicians and research faculty from Dartmouth in a specialized week-long research methods course sponsored by Dartmouth’s Clinical and Translational Research Institute SYNERGY, and taught by senior investigators from NCCC as well as other faculty from Dartmouth’s Geisel School of Medicine.

Devising Research Questions

Selecting research questions and building operational projects in new settings was a challenge for the trainees and mentors from both institutions, who struggled with key questions including how to de-identify patients in a database, navigating the institutional review board, and the important details of accruing patients to their studies. Because these studies were conceived to provide essential information to improve clinical care for patients with cancer at ORCI, the urge to push forward is strong but mitigated by the importance of this as a learning opportunity that will build capacity at ORCI.

Dartmouth in Tanzania, the DarDar Projects

In 2001, Dartmouth established research collaboration with Muhimbili University of Health and Allied Sciences (MUHAS) called DarDar to improve research opportunities for both institutions. Current work includes research in nutrition, booster vaccines for tuberculosis, and hearing. Our DarDarCan research training program joins the DarDar family built on strong bi-cultural relationships with shared passion for solving questions that will have a direct impact on human health.