PurposeThe majority of new diagnoses of pediatric cancer are made in resource-poor
countries, where survival rates range from 5% to 25% compared with 80% in
high-resource countries. Multiple factors, including diagnostic and
treatment capacities and complex socioeconomic factors, contribute to this
variation. This study evaluated the available resources and outcomes for
pediatric patients with cancer at the first oncology treatment center in
northern Tanzania.MethodsQualitative interviews were completed from July to August 2015 to determine
available staff, hospital, diagnostic, treatment, and supportive care
resources. A retrospective review of hospital admissions and clinic visits
from January 2010 to August 2014 was completed. A total of 298 patients were
identified, and data from 182 patient files were included in this
review.ResultsDiagnostic, treatment, and supportive capacities are limited for pediatric
cancer care. The most common diagnoses were Burkitt lymphoma (n = 32), other
non-Hodgkin lymphoma (n = 26), and Wilms tumor (n = 25). A total of 40% of
patients (n = 72) abandoned care. There was a 20% 2-year event-free survival
rate, which was significantly affected by patient age, method of diagnosis,
and year of diagnosis.ConclusionTo our knowledge, this is the first review of pediatric cancer outcomes in
northern Tanzania. The study identified areas for future development to
improve pediatric cancer outcomes, which included strengthening of training
and diagnostic capacities, development of registries and research databases,
and the need for additional research to reduce treatment abandonment.
Low- and middle-income countries (LMICs) have a large burden of cancer with differential population needs and outcomes compared to high-income countries. Access to radiotherapy, especially modern technology, is a major challenge. Modern radiotherapy has been demonstrated with better utility in overall cancer outcomes. We deliberate various challenges and opportunities unique to LMICs' set up for access to modern radiotherapy technology in the light of discussions and deliberations made during the recently concluded annual meeting of Tata Memorial Centre, India. We take examples available from various LMICs in this direction in our manuscript.
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