AI Article Synopsis
- Pediatric brain tumors in low- and middle-income countries, particularly Western Kenya, are less studied than other pediatric cancers, and effective care relies on collaboration among multiple medical departments.
- The study found that, between 2015 and 2022, 79 children were diagnosed with brain tumors, primarily medulloblastoma, with a low 2-year event-free survival rate of 13% and a significant treatment abandonment rate of 46%.
- Improvements in multidisciplinary care were noted from 2020 to 2022, influenced by factors such as resources, knowledge, and relationships among healthcare workers; addressing these barriers is essential for enhancing patient outcomes.
Article 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 levels.
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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| http://dx.doi.org/10.1002/pbc.31544 | DOI Listing |
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