Delay and causes of delay in the diagnosis of childhood cancer in Africa

Abstract

There is considerable delay in diagnosing childhood cancer in the area served by Tygerberg Hospital, due mostly to a physician delay of 20 days on average. The findings of our unit should be correlated with other South African centers. There is a clear need to increase parental awareness of childhood cancer and to intensify the education of nurses and doctors with regard to the warning signs of the disease.

Factors influencing time to diagnosis and treatment among pediatric oncology patients in Kenya

“…The short total delay reported from South-Africa could be a reflection of the superior infrastructure and health-care system in the country and is similar to total delays found in high-income countries, such as Canada which also has a median total delay of 34 days. [15][16][17][18] Health-care system delay in our study was significantly longer than patient delay. This is unlike what has been reported by the Nigerian study where patient delay was longer than health-care system delay as well as the Burkitt lymphoma study in Western Kenya.…”

“…Although the total delay figures are similar to findings in Nigeria where median total delay was 109 days, our figures are longer than what has been reported in other studies done in Africa. [15][16][17][18] A study done in Western Kenya and Uganda, specifically looking at Burkitt lymphoma, reported total delays of 12.1 and 12.9 weeks respectively. This is shorter than what we found though close to what we found in our Non-Hodgkin lymphoma patients who had a mean total delay of 73 days.…”

“…However the Egyptian and South-African study also demonstrated a longer health-care system delay. [15][16][17][18][19] This may mean that parents in our setting come to hospital relatively fast but a lot of delays occur in the health-care system. These could be because medical workers are not able to suspect and make the right diagnosis.…”

“…The sex of the child has been found not to influence diagnosis delay in different studies. 16,17,23,24 This may imply that there are no differences in health-seeking behavior regardless of the gender of the child.…”

Childhood cancer survival rates in two South African units

“…A previous study in the Tygerberg Hospital referral area showed that a considerable delay in diagnosis could be attributed to physicians making a wrong initial diagnosis, delay in performing clinical tests, and delay in obtaining histopathological results. [14] Children in lower socioeconomic areas have less access to care than those in higher-income groups. Awareness campaigns in SA can improve knowledge about child hood malignancies and facilitate early diagnosis, particularly among these underprivileged children.…”