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- Daniel Mackenzie (Zimbabwe)
Introduction
- Daniel Mackenzie (Zimbabwe)
ENHANCING PEDIATRIC CANCER EDUCATION IN GUATEMALA AND POSSIBLY LATIN AMERICA: SMALL STEPS TO IMPROVE EARLY DIAGNOSIS OF PEDIATRIC CANCER.
- Thelma B. Velasquez (Guatemala)
Abstract
Background and Aims
Pediatric cancer can be highly curable disease with timely and correct diagnosis. Formal training to healthcare providers (HCP) in early warning signs of cancer avoids diagnostic error and, along instructions for referral, could reduce lag time and improve outcomes. Aim: To train HCP in early signs, initial approach, and instructions for referral a pediatric patient with suspected cancer.
Methods
Through the financing of My Child Matters Program and collaboration of Francisco Marroquin University we developed an online open-course named “Introduction to Pediatric Oncology”. Registry and access to learning materials is free on website opencourses.ufm.edu. The course is given in Spanish, asynchronous and structured in 4 calendar weeks. It addresses diagnosis of pediatric cancers and management of common emergencies. The activities include 16 videos and podcasts, 9 readings, 11 evaluations, 4 live sessions and 4 discussion forums. After approval of evaluation activities, participants can apply for a digital certificate for the course completion.
Results
By April 05th 2021, 969 participants from 27 different countries were registered in the first launch of the course. Forty seven percent (n=457) were from Guatemala. Thirty one percent (n=303) completed one or more evaluations and 25% (n=243) started week 4. Of participants who started fourth week, 79% were female (n=193); 47% (n=115) were 21-30 and 38% (n=93) 31-40 years old. Fifty six percent (n=137) were physicians, 27% (n=65) medicine students and 10% (n=24) nurses. Fifty seven percent (n=137) invested 1-3 hours/week to complete course activities and 70% (n=169) had completed the learning activities and approved the evaluations. Live sessions have reached 2446 views, and the discussion forums generated 286 comments.
Conclusions
There is a high interest in learning about pediatric cancer signs and diagnosis in Guatemala and Latin America. The impact of this learning experience on early diagnosis of pediatric cancer is still to be determined.
ABANDONMENT OF TREATMENT; A REPORT FROM THE COLLABORATIVE AFRICAN NETWORK FOR CHILDHOOD CANCER CARE AND RESEARCH – CANCARE AFRICA
- George Chagaluka (Malawi)
Abstract
Background and Aims
‘Treatment abandonment’ (or discontinued treatment), is a common and preventable cause of childhood cancer treatment failure in LMIC. In sub-Saharan Africa cost is an overriding reason. In Malawi, a comprehensive package of strategies to enable parents to complete treatment of their child, including no costs for families, was implemented. This reduced 'treatment abandonment' from 19% to 5%. Using the infrastructure of CANCaRe Africa, we studied ‘treatment abandonment’ in Sub-Saharan Africa, to assess potential areas for future intervention.
Methods
A multi-country, multi-centre, prospective, observational cohort study was conducted in five hospitals in Malawi, Cameroon, Kenya, Ghana and Zimbabwe. Children below 16 years of age, with newly diagnosed cancer, treated with curative intent were included. Data were abstracted in real time using standardised case report forms by trained personnel. Frequency and details of factors associated with abandonment of treatment were documented during the first three months of treatment.
Results
We included 252 patients (median age 6.0, range 0.2–15.0 years, 54% male). The most common cancer was Burkitt lymphoma (63/252, 25%). Seven percent of patients (18 of 252) abandoned treatment within three months of starting. Median travel time to the hospital was four hours (range 0.25 - 24 hours). 65% (163 of 252) of patients had to borrow money to reach the hospital. 79% (200 of 252) of patients were counselled on the need to complete treatment. Of the five centres; three are providing free accommodation to families, one provides free medical treatment and full cover of transport costs, three provide meals to the patients and their families.
Conclusions
Funding is needed to implement known successful interventions to prevent abandonment of treatment. We aim to implement a comprehensive package to enable parents to complete treatment, including no costs for families and improved counseling, in all centres participating in CANCaRe Africa.
Exploration of Patient and Parent/Caregiver Engagement in Ten Limited-Resource Countries by a SIOP PODC Task Force
- Alta Bence (South Africa)
Abstract
Background and Aims
Literature on patient and caregiver engagement in pediatric oncology is mostly from high-income countries. The SIOP PODC Engagement Taskforce conducted a literature review in 2018, which produced a total of 32 articles. Six publications were from low- and middle-income countries (LMICs): South Africa, Malawi, Ghana, India, Lebanon and Romania. In 2017, the Taskforce initiated a study to give voice to families on childhood cancer treatment engagement in resource-limited settings.
Methods
Taskforce co-Chairs created terms of reference and recruited countries through CCI/SIOP meetings and personal contacts. Professional qualitative researchers performed individual interviews and focus group discussions in local languages with recent patients: 13-18 years,£2 years off treatment and survivors, 5-8 years off treatment; and parents/caregivers with children £5 years off treatment. CCI-associate NGOs supported local researchers to reach respondents and offered housing/food if needed for researchers. Ten countries participated and a 5-day workshop to share data was held before SIOP/CCI in Lyon, 2019.
Results
During the Lyon workshop, researchers from Ethiopia, Morocco, South Africa, Mexico, El Salvador, Peru, India, Iran, Georgia and Greece (Albanian families seeking treatment in Greece) shared data commonalities/differences and early thematic analysis within the group including 2 physicians and 2 qualitative nurse researchers. The most common theme was ‘communication’. Two publications on core components of communication (information needs, decision making, healing relationships, patient self-management, managing uncertainty, engendering solidarity [validation], and responding to emotions), guided the group discussion. Further analysis of communication and other themes along with planning for sharing all findings with stakeholders completed workshop activities.
Conclusions
Patient and caregiver engagement during childhood cancer treatment in LMICs is not well documented or understood by healthcare stakeholders. Analyses of communication and other thematic findings continue. Our intention is to describe respondents’ engagement challenges and recommendations and create potential interventions for improved engagement in these settings according to respondent preferences and priorities.
Live Q&A
Round-up Session & Closing
- João Bragança (Portugal)