Novel coronavirus mitigation measures implemented by radiotherapy centres in low and middle-income countries: a systematic review

Abstract

background: the aim of the study was to identify strategies adopted by radiotherapy centres in low-and middle-income countries (lMics) to mitigate the effects of cOviD-19. Studies summarising cOviD-19 mitigation strategies designed and implemented by radiotherapy centres in lMics to avoid delays, deferrments and interruptions of radiotherapy services are lacking.Materials and methods: a systematic review was conducted and reported in accordance with the preferred reporting items for systematic review and meta-analysis guideline. Ovid embase, Ovid MeDliNe and ciNaHl were searched for peer-reviewed articles that reported measures adopted by radiotherapy centres in lMics to reduce the risk of cOviD-19. information on different strategies were extracted from the included studies and textual narrative synthesis was conducted. results: Of 60 articles retrieved, eleven were included. Majority of the studies were conducted in china. ten of the included studies employed a qualitative design. Four themes were identified: preparing and equipping staff; reinforcing infection prevention and control policies; strengthening coordination and communication; and maintaining physical distancing. Studies reported that radiotherapy centres had: formed cOviD-19 response multidisciplinary team; maximised the use of telehealth; adjusted the layout of waiting areas; divided staff into teams; dedicated a room for isolating suspected cases; and adopted triage systems. conclusions: local adaptation of established global strategies coupled with timely development of guidelines, flexibility and innovation have allowed radiotherapy leaders to continue to deliver radiotherapy services to cancer patients in lMics during the cOviD-19 crisis. robust data collection must be encouraged in lMics to provide an evidence-based knowledge for use in the event of another pandemic.

The global impact of the COVID-19 pandemic on clinical radiography practice: A systematic literature review and recommendations for future services planning

“…8,34e37,61,74 As medical imaging has played an important role in both the diagnosis and management of COVID-19 patients, the pandemic has highlighted existing global discrepancies in radiography resource availability. 35,37,61,74 The findings suggest that the knowledge-base of radiographers about the pandemic has improved over time. For example, Kotian and colleagues 11 reported relatively low knowledge of COVID-19 among India's radiography workforce at the initial stages of the pandemic (March, 2020), similar to the baseline findings reported among their Irish counterparts at approximately the same period of the pandemic.…”

“…Of note, these new clinical initiatives including the use of information technologies to enhance remote working in clinical radiotherapy follow-up consultations and planning are not universal. 8,12,13,21,34,42,61,62,75,77,78 Further highlighting the need for adaptation of established global strategies for use within local settings.…”

“…30e33, 60 In line with these recommendations, radiotherapy departments underwent resource and technical re-organisation to allow the continuation of daily cancer care provision. 23e28, 34,61,62 The recommendations included the implementation of strict hygiene protocols to guarantee the safety of cancer patients, many of whom are generally immunocompromised and at increased risk of COVID-19 complications, and of staff administering the treatments. Additionally, strict triage systems and the use of hypofractionation protocols designed for specific cancers were rapidly implemented 30e33 to allow cancer care continuation during the pandemic.…”

Radiation oncology practice during COVID-19 pandemic in developing countries

“…A recent systematic review published by Donkor et al [ 16 ] addressed the approaches used to mitigate the impact of COVID-19 on radiotherapy centers in low- and middle-income countries. Eleven studies were included in review, and the methods used to cope with COVID-19 in RT departments were as follows: forming COVID-19 response multidisciplinary teams; increasing the use of telemedicine; modifying the layout of waiting areas; reducing staff; isolating patients suspected of having COVID-19; and adopting triage systems.…”

An umbrella review of systematic reviews on the impact of the COVID-19 pandemic on cancer prevention and management, and patient needs

“…In addition, several studies have highlighted deterioration of psychological well-being of patients with cancer, and psychological, ethical, spiritual, and financial needs of patients with cancer were also affected ( Zhang et al, 2022 ; Kirby et al, 2022 ). While several systematic reviews have examined the impact of COVID-19 on cancer care, they evaluated different outcomes and periods of the pandemic, and thus the available review findings are rather fragmented ( Teglia et al, 2022a ; Teglia et al, 2022b ; Donkor et al, 2021 ; Gascon et al, 2022 ; Hojaij et al, 2020 ; Legge et al, 2022 ; Murphy et al, 2022 ; Gadsden et al, 2022 ; Majeed et al, 2022 ). A comprehensive review of impact of COVID-19 on several aspects of cancer would be essential to understand gaps and scale-up evidence-based interventions, including learning lessons for future pandemics.…”