Delays in diagnosis and treatment among children with cancer: Egyptian perspective

Abdelmabood, Suzy; Kandil, Shaimaa; Megahed, Ahmed; Fouda, Ashraf

doi:10.26719/2017.23.6.422

Cited by 14 publications

(28 citation statements)

References 11 publications

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“…16 In contrast, a later study in Singapore reported a much lower median physician delay of approximately 8 days. 11 Compared to physician delay, median patient delay was lower for South Africa and Indonesia (median -5 days), 12,15 and Canada (median -9 days), 9 similar to findings from the current study; however, the median patient delay was higher in Singapore, reported as 21 days. 11 Median patient delay was also higher in several studies in sub-Saharan Africa as compared to physician delay.…”

Section: Resultssupporting

confidence: 83%

“…9,12 Regionally, other countries in the Middle East generally demonstrated a lower median in number of days of delayed diagnosis ranging from 30 days in Iran to 47 days in Egypt. [13][14][15] In the more resource-limited setting of Indonesia the median total number of days of delay was as high as 70. 16 Countries in sub-Saharan Africa demonstrated the longest delays in diagnosis, ranging from a median of 85 days in Kenya to 111 days in Nigeria.…”

Section: Resultsmentioning

confidence: 99%

“…9 In Egypt, physician or diagnostic delay was 28 and patient delay was 3 and 8 days for two different studies. 14,15 In Indonesia, the median delay related to the health care system was higher, at 49 days as compared to patient delay which was 5 days. 16 In contrast, a later study in Singapore reported a much lower median physician delay of approximately 8 days.…”

Section: Resultsmentioning

confidence: 99%

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Delay in diagnosis of cancer in Iraq: Implications for survival and health outcomes at Children’s Welfare Teaching Hospital in Baghdad

Yadalla

Al‐Jadiry

Faraj

et al. 2021

Journal of Global Health Reports

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BackgroundDecades of political and economic instability have taken a significant toll on health outcomes among children in Iraq. In a health system with optimal resources, five-year rates of survival for childhood cancer would exceed 80%; however, a study in Iraq demonstrated a much lower survival rate of 50%, reflecting a disrupted health care infrastructure. Under such conditions, it is a struggle to sustain good treatment outcomes. The aims of the present study are to: i) estimate the median time from initial presentation to diagnosis of childhood cancer at a tertiary center in Iraq; and ii) examine sociodemographic and clinical factors associated with delay in diagnosis in this vulnerable population. MethodsA cohort of 346 children presenting for cancer care between January 1-December 31, 2012 was included in the study. Data were obtained through structured interviews with caregivers and from medical charts. The median total delay in cancer diagnosis was calculated in addition to the median patient delay and physician delay. Factors associated with delay in diagnosis were also examined. ResultsThe majority of the patients were less than five years of age and 59% were boys. The median number of days from the onset of symptoms to diagnosis was 55 (range: 3-1,093). This was largely due to physician delay. Clinical factors associated with a longer delay to diagnosis included number of doctors visited, as well as tumor location and type. ConclusionsDespite recent advances in cancer treatment outcomes, there are persistent disparities between high-resource versus low-and middle-income countries in childhood cancer survival. Lack of access to care, medication shortages, and inadequate access to medical equipment fuel these disparities. Such factors contribute to delay in access to care and increased mortality risk for children suffering from cancer. The situation will continue unless action to improve access to quality care is taken at national and international levels.During the last several decades the health care infrastructure in Iraq has been seriously compromised as a result of war, economic sanctions, and political violence. 1 During the 1970s, Iraq had one of the more robust health care sys-tems in the Middle East, with 172 hospitals and 1,200 primary care clinics that provided free services through a public single-payer financing mechanism. 2 However, the first Gulf War (1980)(1981)(1982)(1983)(1984)(1985)(1986)(1987)(1988), i.e. the Iran-Iraq war, ushered in a Equal contribution author with Mazin F. Al-Jadiry. Equal contribution author with Widad Yadalla. a b Yadalla W, Al-Jadiry MF, Faraj SA, et al. Delay in diagnosis of cancer in Iraq: Implications for survival and health outcomes at Children's Welfare Teaching Hospital in Baghdad.

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Section: Resultssupporting

confidence: 83%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Delay in diagnosis of cancer in Iraq: Implications for survival and health outcomes at Children’s Welfare Teaching Hospital in Baghdad

Yadalla

Al‐Jadiry

Faraj

et al. 2021

Journal of Global Health Reports

View full text Add to dashboard Cite

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“…9,11,[13][14][15] However, only a few articles have been published on this subject from developing countries. [16][17][18][19] We do not have any study from the author's region in India done on routes of presentation of childhood cancer, time to diagnosis (TTD), and time to start treatment.…”

Section: Introductionmentioning

confidence: 99%

A Retrospective Study of Factors Affecting Pathway and Time to Diagnosis, Time to Treatment in Children with Cancer in a Single Center in South India

Lashkari

Prasada

Joshi

et al. 2021

Indian J Med Paediatr Oncol

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Introduction The overall cure rate of childhood cancers is above 79% in the developed world, whereas in the developing world, like in India, it is around 50%. It is vital to know the routes of presentation and factors affecting the presentation of childhood cancers in primary, secondary, and tertiary care to design a better survival strategy in childhood cancer. Objective The aim of this study was to know the factors affecting the time to diagnosis and time to treatment in children with cancers in a single center in South India. Materials and Methods It was a retrospective cohort study of children diagnosed with cancer between January 1, 2014 and December 31, 2016 at the pediatric oncology unit, KMC Hospital Mangalore, India. The patient interval, time to diagnosis, patient's family, economic background, parental education, and referral pattern were recorded, and its impact on the time taken to diagnosis was studied. The data was analyzed using SPSS 20.0 software. Results Out of 111 children, 72 were boys (64.8%). Fifty-one (46%) children belonged to the less than 5-year age group. The most common cancer was acute lymphoblastic leukemia, diagnosed in 50% (56/111) children, followed by acute myeloid leukemia in 14/111(12.6%), brain tumors in 9 (8.1%), and neuroblastoma in 10 (9%) children. The median patient interval/patient delay was 14 days (1–90 days), referral interval was 14 days (1–150 days), and overall time to diagnosis was 41 days (1–194 days). The first contact was the pediatrician in 86/111 (77.4%). Sixty-four percent (71/111) referral came from a secondary care hospital, and the remaining from the outpatient clinics. There was no difference in sex and patient interval (p = 0.278) and overall time to diagnosis (p = 0.4169), age (p = 0.041), mother’s education (p = 0.034), and type of cancer (p = 0.013) were three critical factors that determined the time to diagnosis. Conclusion Majority of the children diagnosed with cancer presented via referral from pediatricians. An equal number of them were referred to as routine and emergency patients. Age, mother's education, and type of cancers were the crucial factors associated with the overall time taken to diagnosis.

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“…In a study of pediatric oncology patients at a large university hospital in Egypt, Abdel‐Mabood reported an initial misdiagnosis of referred patients with a median total delay of 37 days. These findings alert to the need for increasing the diagnostic yield of general hematology laboratories especially in remote areas …”

Section: Introductionmentioning

confidence: 93%

Challenges to laboratory hematology practice: Egypt perspective

Rizk

2018

Int J Lab Hematology

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Laboratory hematology is an integral part of all clinical laboratories along the extensive healthcare facilities in Egypt. The aim of this review is to portrait the laboratory hematology practice in Egypt including its unique socioeconomic background, blood disease pattern, education and training, regulatory oversight, and the related challenges. Current practice varies widely between different parts of the healthcare system in terms of the range of tests, applied techniques, workforce experience, and quality of service. The national transfusion service (NBTS) in Egypt has been recently upgraded and standardized according to the World Health Organization (WHO) guidelines. Formal postgraduate education roughly follows the British system. Laboratory hematology specialization is achieved through 2-3 years masters' degree followed by 2-4 years doctorate degree in clinical pathology with training and research in hematology. Improvement of laboratory hematology education is recently undergoing a reform as a part of the modernization of higher education policy and following the standards developed by the National Quality Assurance and Accreditation Agency (NQAAA). Accreditation of medical laboratories is recently progressing with the development of the "Egyptian Accreditation Council" (EGAC) as the sole accreditation body system and training of assessors. Current laboratory system has many challenges, some are related to the inadequate system performance, and others are unique to laboratory hematology issues. The rapid technological advances and therapeutic innovations in hematology practice call for an adapting laboratory system with continuous upgrading.

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Delays in diagnosis and treatment among children with cancer: Egyptian perspective

Cited by 14 publications

References 11 publications

Delay in diagnosis of cancer in Iraq: Implications for survival and health outcomes at Children’s Welfare Teaching Hospital in Baghdad

Delay in diagnosis of cancer in Iraq: Implications for survival and health outcomes at Children’s Welfare Teaching Hospital in Baghdad

A Retrospective Study of Factors Affecting Pathway and Time to Diagnosis, Time to Treatment in Children with Cancer in a Single Center in South India

Challenges to laboratory hematology practice: Egypt perspective

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