Treating Nephroblastoma in Rwanda: Using International Society of Pediatric Oncology Guidelines in a Novel Oncologic Care Model

Shyirambere, Cyprien; Xu, Mary Jue; Elmore, Shekinah N.C.; Fadelu, Temidayo; May, Leana; Tapela, Neo; Umuhizi, Denis Gilbert; Uwizeye, Frank Regis; Driscoll, Caitlin; Muhayimana, Clemence; Hategekimana, Vedaste; Rubagumya, Fidel; Nzayisenga, Ignace; Shulman, Lawrence N.; Mpunga, Tharcisse; Lehmann, Leslie

doi:10.1200/jgo.2015.000067

Cited by 14 publications

(11 citation statements)

References 23 publications

(36 reference statements)

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“…Although many children are achieving a sustained remission from their cancer, significant improvements are necessary to attain treatment outcomes consistent with those seen in high-income countries. Children with Wilms tumor had a 2-year OS rate of 73%, which is comparable to Wilms tumor survival of other African institutional experiences that ranged from 32% to 79% 29 - 32 but which lags behind the United States experience of 90%. 21 Neuroblastoma outcomes were particularly discouraging, with no survivors in this cohort.…”

Section: Discussionmentioning

confidence: 55%

Establishing a Pediatric Hematology-Oncology Program in Botswana

Slone

Wally

et al. 2018

JGO

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PurposeAnnually, 300,000 children are diagnosed with cancer, and the majority of these children live in low- and middle-income countries (LMICs). Currently, there is incomplete information on pediatric cancer incidence, diagnosis distribution, and treatment outcomes in Africa. Since 2007, a pediatric hematology-oncology program has been operating in Botswana through a partnership between the Botswana government, Baylor College of Medicine, and Texas Children’s Hospital.MethodsTo better understand patient characteristics and outcomes at Botswana’s only pediatric cancer program, a hospital-based data base—the Botswana Pediatric Oncology Database—was established in 2014. Children younger than 18 years of age at the time of diagnosis who presented between 2008 and 2015 were included. Data for this study were extracted in February 2016.ResultsOf the 240 potential enrollees, 185 (77%) children met eligibility for this study. The median age was 6.4 years, and 50.8% were male. Leukemia was the most common malignancy representing 18.9% of the cohort and 88.1% of the total cohort had a histopathologic diagnosis. HIV seropositivity was confirmed in 13.5%. The 2-year overall survival of all pediatric cancer diagnoses was 52.4%. Abandonment of treatment occurred in 3.8% of patients.ConclusionIn the first 9 years of the program, capacity has been developed through a longstanding partnership between Botswana and Baylor College of Medicine/Texas Children’s Hospital that has led to children receiving care for cancer and blood disorders. Although continued improvements are necessary, outcomes to date indicate that children with cancer in Botswana can be successfully diagnosed and treated.

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Section: Discussionmentioning

confidence: 55%

Establishing a Pediatric Hematology-Oncology Program in Botswana

Slone

Wally

et al. 2018

JGO

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“…69 For nephroblastoma, the 68-70% current survival rates reported were higher than 41% reported from Kenya 64 and 56% from Rwanda. 70,71 The participation of Cameroon pediatric oncology units in international collaborative research on nephroblastoma could be regarded as a good example and potential reason for improved survival rate. 46,53,72,73 Similar to this report, similar problems with treatment toxicity, malnutrition, and nonadherence were reported elsewhere in Africa.…”

Section: Discussionmentioning

confidence: 99%

“…Adding anthracycline to the treatment can potentially improve survival rates as demonstrated in Malawi 69 . For nephroblastoma, the 68–70% current survival rates reported were higher than 41% reported from Kenya 64 and 56% from Rwanda 70,71 . The participation of Cameroon pediatric oncology units in international collaborative research on nephroblastoma could be regarded as a good example and potential reason for improved survival rate 46,53,72,73 …”

Section: Discussionmentioning

confidence: 99%

Two decades of childhood cancer care in Cameroon: 2000–2020

Afungchwi

Kruger

Kouya

et al. 2021

Pediatric Blood & Cancer

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Background: Before the year 2000, there was no dedicated childhood cancer service in Cameroon. The aim of this study was to investigate the progress made with pediatric oncology care in Cameroon from 2000 to 2020.Method: A literature search was conducted for published articles on childhood cancer in Cameroon and relevant documents, and conference abstracts were reviewed. The articles were analyzed under the themes: awareness, diagnosis, epidemiology, treatment, outcome, advocacy, partnerships, traditional and complementary medicine, palliative care, and capacity building.Results: Low awareness on childhood cancer was addressed with education activities targeting the general population and health care professionals. Cancer diagnosis was achieved with cytology, histology, and simple imaging. Management for common and curable cancers was implemented with use of modified treatment regimens for lowand middle-income settings. Nutritional support was shown to mitigate the effects of malnutrition on treatment toxicity, and support was provided for transportation and accommodation. There was good collaboration between the pediatric oncology professionals nationally and twinning with international partners. Capacity building activities led to the availability of three pediatric oncologists and pediatric oncology-trained nurses. Advocacy nationally led to the support of the Ministry of Health with pediatric oncology-specific priority actions in the latest national cancer control plan. Conclusion:Childhood cancer should receive the necessary attention of health care policymakers in Cameroon. With continued commitment of government, nongovernmental organizations, charities, childhood cancer specialists, patient and parent groups, there should be an improved future for children with cancer in Cameroon.

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“…The limited study window and restriction to newly diagnosed cases at only one site left us with a small sample size for many of our reported conditions. Additionally, we do not report extensive disease-specific outcomes, but this information has been published elsewhere for several of the disease groups in combination with the cohort from Butaro Cancer Center of Excellence [22,[25][26][27][28][29][30][31]. An additional limitation of our study is that transfer data was not available in the EMR, so transferred patients may have been recorded as LTFU.…”

Section: Discussionmentioning

confidence: 99%

Integration of Chronic Oncology Services in Noncommunicable Disease Clinic in Rural Rwanda

Rutayisire

Mutabazi

Bayingana

et al. 2020

Annals of Global Health

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Background: In rural sub-Saharan Africa, access to care for severe non-communicable diseases (NCDs) is limited due to myriad delivery challenges. We describe the implementation, patient characteristics, and retention rate of an integrated NCD clinic inclusive of cancer services at a district hospital in rural Rwanda. Methods: In 2006, the Rwandan Ministry of Health at Rwinkwavu District Hospital (RDH) and Partners In Health established an integrated NCD clinic focused on nurse-led care of severe NCDs, within a single delivery platform. Implementation modifications were made in 2011 to include cancer services. For this descriptive study, we abstracted medical record data for 15 months after first clinic visit for all patients who enrolled in the NCD clinic between 1 July 2012 and 30 June 2014. We report descriptive statistics of patient characteristics and retention. Results: Three hundred forty-seven patients enrolled during the study period: oncology-71.8%, hypertension-10.4%, heart failure-11.0%, diabetes-5.5%, and chronic respiratory disease (CRD)-1.4%. Twelve-month retention rates were: oncology-81.6%, CRD-60.0%, hypertension-75.0%, diabetes-73.7%, and heart failure-47.4%. Conclusions: The integrated NCD clinic filled a gap in accessible care for severe NCDs, including cancer, at rural district hospitals. This novel approach has illustrated good retention rates.

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Treating Nephroblastoma in Rwanda: Using International Society of Pediatric Oncology Guidelines in a Novel Oncologic Care Model

Cited by 14 publications

References 23 publications

Establishing a Pediatric Hematology-Oncology Program in Botswana

Establishing a Pediatric Hematology-Oncology Program in Botswana

Two decades of childhood cancer care in Cameroon: 2000–2020

Integration of Chronic Oncology Services in Noncommunicable Disease Clinic in Rural Rwanda

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