Pediatric Brain Tumors in Western Kenya: Patient Outcomes and Healthcare Providers’ Perspectives

IF 2.4 3区医学 Q2 HEMATOLOGY

Pediatric Blood & Cancer Pub Date : 2025-01-11 DOI:10.1002/pbc.31544

Jesse Lemmen, Njie Albertine, Miyaada Abdi, Nilesh Mohan, Kibet Keitany, Marie Eliasson-Hofvander, Gertjan Kaspers, Festus Njuguna

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引用次数: 0

Abstract

Background

Pediatric brain tumors are understudied compared to other pediatric malignancies in low- and middle-income countries. Care delivery is inherently dependent on collaboration between multiple departments. This study aimed to present baseline data of pediatric neuro-oncology care in Western Kenya and illustrate barriers and facilitators of multidisciplinary care.

Methods

We performed a mixed-methods study using medical records and interviews. Children below age 19 years, managed for a brain tumor at the neurosurgery or pediatric oncology departments between 2015 and 2022, were included. Various cadres (consultants, residents, medical officers, clinical officers, nurses, counselors) and teams (neurosurgery, pediatric oncology, radio-oncology, radiology, pathology) involved in pediatric brain tumor care participated.

Results

Seventy-nine brain tumor patients were identified. The most prevalent confirmed diagnosis was medulloblastoma (n = 21). Most patients underwent surgery (n = 60; 76%). Event-free survival rate at 2 years was 13%. Abandonment was the most common (n = 36; 46%) treatment failure. Multidisciplinary consultation occurred more frequently between 2020 and 2022 than between 2015 and 2019 (OR 2.7 [95% CI: 1.0–6.9; p = 0.04]). Barriers and potential facilitators of multidisciplinary management were resources, diagnostic and therapeutic flow, standards, knowledge, information comprehension, and work relationships. Themes interacted at a governmental, facility, and community level.

Conclusion

This baseline overview of pediatric neuro-oncology care in Western Kenya showed that survival of children with pediatric brain tumors was poor and treatment abandonment was common. Strengthening the capacity at different organizational levels will improve continuity of care and expand the knowledge to support holistic multidisciplinary care for children with brain tumors in Kenya.

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儿童脑肿瘤在肯尼亚西部：患者的结果和医疗保健提供者的观点。

背景：与低收入和中等收入国家的其他儿科恶性肿瘤相比，儿童脑肿瘤的研究不足。医疗服务本质上依赖于多个部门之间的合作。本研究旨在介绍肯尼亚西部儿童神经肿瘤护理的基线数据，并说明多学科护理的障碍和促进因素。方法：我们使用病历和访谈进行了一项混合方法研究。研究对象包括2015年至2022年期间在神经外科或儿科肿瘤科治疗脑肿瘤的19岁以下儿童。参与儿童脑肿瘤治疗的各种干部（顾问、住院医师、医务人员、临床人员、护士、辅导员）和小组（神经外科、儿科肿瘤学、放射肿瘤学、放射学、病理学）参加了会议。结果：共发现79例脑肿瘤患者。最常见的确诊为成神经管细胞瘤（n = 21）。大多数患者接受手术治疗(n = 60；76%)。2年无事件生存率为13%。遗弃是最常见的(n = 36；46%)治疗失败。2020年至2022年多学科会诊的发生频率高于2015年至2019年(OR 2.7 [95% CI: 1.0-6.9；P = 0.04])。多学科管理的障碍和潜在的促进因素是资源、诊断和治疗流程、标准、知识、信息理解和工作关系。主题在政府、设施和社区层面相互作用。结论：肯尼亚西部儿童神经肿瘤护理的基线概述显示，儿童脑肿瘤患者的生存率很低，放弃治疗很常见。加强不同组织层面的能力将改善护理的连续性，并扩大知识，以支持对肯尼亚脑肿瘤儿童的全面多学科护理。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Pediatric Blood & Cancer 医学-小儿科

CiteScore

4.90

自引率

9.40%

发文量

546

审稿时长

1.5 months

期刊介绍： Pediatric Blood & Cancer publishes the highest quality manuscripts describing basic and clinical investigations of blood disorders and malignant diseases of childhood including diagnosis, treatment, epidemiology, etiology, biology, and molecular and clinical genetics of these diseases as they affect children, adolescents, and young adults. Pediatric Blood & Cancer will also include studies on such treatment options as hematopoietic stem cell transplantation, immunology, and gene therapy.