Abandonment of childhood cancer treatment in Western Kenya

Abstract

Prevention of childhood cancer treatment abandonment requires improved access to health insurance, financial or transportation support, proper parental education, psychosocial guidance and ameliorated communication skills of healthcare providers.

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

“…30,33,34 It may contribute to the lower reported than expected childhood cancer incidence (100-110 children versus 700 children) in the service area of MTRH. 14 In conclusion we found that total delay is much longer than has been reported in most previous studies. The only factor that significantly affected total delay was use of alternative treatment.…”

Treatment abandonment in children with cancer in Sub‐Saharan Africa: Systematic literature review and meta‐analysis

“…In Indonesia, a parental education programme was introduced for patients with acute lymphoblastic lymphoma (ALL) with the aim of providing readily accessible information about the disease and benefits of treatment, this resulted in a decrease in treatment abandonment from 14% to 2% (Mostert et al., ). Healthcare professionals can also help to decrease problems faced by parents lacking education by providing the correct information regarding the disease, treatment options and help to settle cultural beliefs that cancer is not curable (Njuguna et al., ).…”

“…Seven studies were excluded; a full list of these and the reasons for exclusion are shown in the supplementary material. All studies were cohort studies, four were single‐centre (Mostert et al., ; Mtete et al., ; Njuguna et al., ; Slone et al., ) and two multi‐centre (Axt et al., ; Libes et al., ). The countries where the studies took place were Kenya (Axt et al., ; Libes et al., ; Mostert et al., ; Njuguna et al., ), Malawi (Mtete et al., ) and Zambia (Slone et al., ).…”

“…The risk of bias in each study was assessed using the Newcastle‐Ottawa Scale, the summary of the findings is shown in Table . Briefly, all studies scored highly for selection apart from one where the comparison cohort had different forms of cancer (Mtete et al., ); for comparability two studies had no comparison group at all meaning only proportions could be calculated (Libes et al., ; Njuguna et al., ); and all studies had large loss of subjects of unknown significance. Two studies also used self‐report measures (Libes et al., ; Njuguna et al., ), although as this subject has high saliency and this is an appropriate way of collecting these data, no reduction was made for this.…”

“…Six studies were included in the final analysis, of these: three were retrospective reviews of children treated for Wilm's tumour in Kenya (Axt et al., ) and various forms of cancer in Kenya (Mostert et al., ) and Zambia (Slone et al., ); two were based on interviews with parents of children who had abandoned care in Kenya (Libes et al., ; Njuguna et al., ) and one compared a retrospective general cancer group with prospective Kaposi's sarcoma and Burkett's lymphoma groups in Malawi (Mtete et al., ). For the two studies based on interviews with parents no comparison group existed, so only the proportions who attributed abandonment of treatment to different factors could be calculated; for other studies, the risk and relative risk of having the characteristic among those who did and did not abandon treatment was able to be calculated.…”