Risk factors and reasons for treatment abandonment among children with lymphoma in Malawi

Stanley, Christopher C.; Gronde, Toon van der; Westmoreland, Kate; Salima, Ande; Amuquandoh, Amy; Itimu, Salama; Manda, Agness; Mtete, Idah; Butia, Mercy; Mpasa, Atupele; Wachepa, Stella; Fox, Paula; Wasswa, Peter; Kazembe, Peter N.; El‐Mallawany, Nader Kim; Gopal, Satish

doi:10.1007/s00520-017-3917-z

Cited by 28 publications

(50 citation statements)

References 17 publications

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“…Geographical factors such as the place of residency and the time needed to travel to a referral facility have been described by some studies as important factors for abandonment, whereas other studies have found this factor to be inconsistent . This study shows that children living in a rural setting had a significantly increased risk of treatment abandonment, as previously described by other authors .…”

Section: Discussionsupporting

confidence: 81%

Factors associated with abandonment of therapy by children diagnosed with solid tumors in Peru

Vásquez

Díaz

Chávez

et al. 2018

Pediatric Blood & Cancer

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Section: Discussionsupporting

confidence: 81%

Factors associated with abandonment of therapy by children diagnosed with solid tumors in Peru

Vásquez

Díaz

Chávez

et al. 2018

Pediatric Blood & Cancer

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“…Eighteen studies met our inclusion criteria for the systematic review (Table 1). 29,32,33,35,40,41,[49][50][51][52][53][54][55][56][57][58][59][60] Two studies 41,51 were subsequently excluded from the meta-analysis because they did not report data necessary to determine sex-disaggregated rates of treatment abandonment.…”

Section: Resultsmentioning

confidence: 99%

“…A number of studies have applied such data to examine factors influencing equity in service uptake and rates of treatment abandonment in childhood cancers generally. 7,8,10,[28][29][30][31][32][33][34][35][36][37][38][39][40][41] Very few studies, however, have specifically examined association between sex and abandonment rates. 42 There is a need to fill this evidence gap to guide health system planners in a gender-sensitive approach to the implementation of cancer control programs and ensure that, in the pursuit of universal health coverage, girls with cancer are not left behind.…”

mentioning

confidence: 99%

Treatment abandonment in children with cancer: Does a sex difference exist? A systematic review and meta‐analysis of evidence from low‐ and middle‐income countries

Palagyi

Balane

Shanthosh

et al. 2020

Intl Journal of Cancer

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In this systematic review and meta-analyses, we sought to determine sex-disparities in treatment abandonment in children with cancer in low-and middle-income countries (LMICs) and identify the characteristics of children and their families most disadvantaged by such abandonment. Sex-disaggregated data on treatment abandonment were collated from the available literature and a random-effects meta-analysis was conducted to compare the rates in girls with those in boys. Subgroup analyses were conducted in which studies were stratified by design, cancer type and the Gender Inequality Index of the country of study. Eighteen studies were included in the systematic review and of these studies, 16 qualified for the meta-analysis, representing 10 754 children. The pooled rate of treatment abandonment overall was 30%. We observed no difference in the proportion of treatment abandonment in girls relative to estimates observed in boys (rate ratio [RR] 0.95, 95% CI: 0.79-1.15; P = .61). There was significant heterogeneity across the included studies and in the pooled estimate of RR for girls vs boys (both I 2 > 98%). Subgroup analyses did not reveal any effect on abandonment risk. Risk factors for abandonment observed fell into three main categories: socio-demographic; geographic; and travel-related. In conclusion, a high rate of treatment abandonment (30%) was observed overall for children with cancer in included studies in LMICs, although this was variable and context specific. No evidence of gender bias in childhood cancer treatment abandonment rates across LMICs was found. Given that the risk factors for abandonment are context specific, in-depth country-level analyses may provide further insights into the role of a child's gender in treatment abandonment decisions.

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“…Many households experience cancer diagnoses when they would expect to be at their most economically productive 4 . For the few patients who are able to access potentially curative cancer therapy, treatment abandonment rates are high 5,6 .…”

Section: Introductionmentioning

confidence: 99%

“…This has been changed to 'treatment abandonment' as follows: Pg. 3 For the few patients who are able to access potentially curative cancer therapy, treatment ○ abandonment rates are high 5,6 .' There is a comma missing following 'health' in the Lancet quote (paragraph 2 A comma has been inserted: Pg.…”

Section: Introductionmentioning

confidence: 99%

Study protocol for a single-centre observational study of household wellbeing and poverty status following a diagnosis of advanced cancer in Blantyre, Malawi - ‘Safeguarding the Family’ study

et al. 2020

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Background: Many households in low-and-middle income countries face the additional burden of crippling out-of-pocket expenditure when faced with a diagnosis of life-limiting illness. Available evidence suggests that receipt of palliative care supports cost-savings for cancer-affected households. This study will explore the relationship between receipt of palliative care, total household out-of-pocket expenditure on health and wellbeing following a first-time diagnosis of advanced cancer at Queen Elizabeth Central Hospital in Blantyre, Malawi. Protocol: Patients and their primary family caregivers will be recruited at the time of cancer diagnosis. Data on healthcare utilisation, related costs, coping strategies and wellbeing will be gathered using new and existing questionnaires (the Patient-and-Carer Cancer Cost Survey, EQ-5D-3L and the Integrated Palliative Care Outcome Score). Surveys will be repeated at one, three and six months after diagnosis. In the event of the patient’s death, a brief five-item questionnaire on funeral costs will be administered to caregivers not less than two weeks following the date of death. Descriptive and Poisson regression analyses will assess the relationship between exposure to palliative care and total household expenditure from baseline to six months. A sample size of 138 households has been calculated in order to detect a medium effect (as determined by Cohen’s f 2=0.15) of receipt of palliative care in a regression model for change in total household out-of-pocket expenditure as a proportion of annual household income. Ethics and dissemination: The study has received ethical approval. Results will be reported using STROBE guidelines and disseminated through scientific meetings, open access publications and a national stakeholder meeting. Conclusions: This study will provide data on expenditure for healthcare by households affected by advanced cancer in Malawi. We also explore whether receipt of palliative care is associated with a reduction in out-of-pocket expenditure at household level.

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Risk factors and reasons for treatment abandonment among children with lymphoma in Malawi

Abstract: These findings highlight families at risk for treatment abandonment, underlying reasons, and opportunities to improve retention in care for pediatric cancer patients in SSA.

Cited by 28 publications

References 17 publications

Factors associated with abandonment of therapy by children diagnosed with solid tumors in Peru

Factors associated with abandonment of therapy by children diagnosed with solid tumors in Peru

Treatment abandonment in children with cancer: Does a sex difference exist? A systematic review and meta‐analysis of evidence from low‐ and middle‐income countries

Study protocol for a single-centre observational study of household wellbeing and poverty status following a diagnosis of advanced cancer in Blantyre, Malawi - ‘Safeguarding the Family’ study

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