The iTAG Project led by Dr. Selekwa Msiba

The Global Cancer Program is thrilled to highlight the impactful work of the iTAG (Improving Tracheostomy and Gastrostomy Tube Care) project, led by the dedicated Dr. Selekwa Msiba. In partnership with Muhimbili University of Health and Allied Sciences (MUHAS), this initiative has received support from the Coalition for Implementation Research in Global Oncology (CIRGO) to improve tracheostomy and gastrostomy care for cancer patients in Tanzania. Dr. Msiba’s unique approach reflects the 2025 World Cancer Day theme of “United by Unique”— demonstrating how individual contributions can drive global progress in cancer care.

Head and neck cancers and esophageal cancer are among the most prevalent malignancies in East Africa, and many patients experience airway obstruction and difficulty swallowing which require tracheostomy and gastrostomy procedures. At Muhimbili National Hospital (MNH), the largest referral hospital in Tanzania, approximately 140 tracheostomies and 130 gastrostomy tubes are placed annually. Despite the prevalence of these procedures, patients often face complications that lead to unplanned hospital readmissions and treatment delays, negatively affecting outcomes.

Dr. Selekwa Msiba: From Observer to Innovator

Dr. Msiba, a Clinical Research Coordinator with nearly a decade of experience, noted these challenges while supporting other studies in the endoscopy unit and leveraged his clinical research experience and mentorship through the MUHAS-ORCI-UCSF Cancer Collaboration to design an innovative proposal addressing this critical need. The CIRGO funding provided Dr. Selekwa Msiba with the opportunity to grow into a research leadership role, building his expertise in designing and implementing context-specific interventions while addressing critical healthcare challenges in Tanzania.

Dr. Msiba reflects on his journey: “As a medical doctor and researcher, addressing patients' pressing needs identified through clinical practice or research is a rewarding feeling. Observing patients with tracheostomy and gastrostomy tubes succumbing to avoidable complications... drove me to develop interventions tailored to our setting... This effort is a true reflection of good mentorship from both local and international mentors fostered through the Global Cancer Program and the MUHAS-ORCI-UCSF Cancer Collaboration.”

His words serve as a powerful message to aspiring researchers: “Inspiration starts within peers and self. By remaining vigilant to the challenges in our clinical and research settings, we can initiate solutions that the community expects from us.”  

iTAG’s Research and Milestones  The iTAG study employs an intervention mapping framework to design, implement, and evaluate a context-appropriate strategy. Key accomplishments to date include:

• Mentorship and Capacity Building: Trainees from Tanzania, UCSF, and the University of Pennsylvania have gained expertise in survey development, RedCap database creation, community engagement, and manuscript writing.
• Conference Presentations: Study findings have been showcased at prestigious platforms, including the 2023 Global Tracheostomy Collaborative (GTC) Symposium, the American Academy of Otolaryngology–Head and Neck Surgery Annual Meeting, and the NCI Annual Symposium on Global Cancer Research.
• Publications: A scoping review on tracheostomy care was published in PLOS Global Public Health, and a second review on gastrostomy care in low- and middle-income countries is under consideration.
• Partnerships: During a recent visit to Tanzania by Dr. David Roberson, Co-Founder of the Global Tracheostomy Collaborative, discussions were held with MNH leadership about the possibility of joining the GTC. MNH would become the first hospital in a low- and middle-income country to participate in this global quality improvement initiative.

Next Steps

The iTAG team is preparing to initiate training sessions for nurses, patients, and caregivers, equipping them with essential knowledge and skills for tracheostomy and gastrostomy care both in hospital and home settings. This training aims to reduce complications, enhance patient outcomes, and empower caregivers.

Dr. Msiba’s leadership exemplifies the transformative potential of clinician-led research addressing local challenges. The iTAG project not only advances cancer care in Tanzania but also sets a precedent for implementation science in similar contexts worldwide.