Background and Aims

According to Lancet Oncology Commission (2020) stark inequalities in access to cancer prevention, diagnostic, treatment and care for children between Low and Middle-Income Countries (LMIC) and High-Income countries, result in large global variations in survival: estimates of 5-year net childhood cancer survival show a huge gap between Eastern Africa (8.1%) and North America (83%).

At current levels of access and referral, it's estimated that 44.9% of 13.7 million new cases of childhood cancer foreseen for 2020-2050 will go undetected and 11.1 million children will die of cancer. Among them 9.3 million (84.1%) will be in LMIC because of current demographic trends and differences in survival rates.

Since 2018 AFRON and Soleterre implement ABLE+ programme (Awareness for Burkitt Lymphoma Eradication) in Northern Uganda in collaboration with St. Mary's Lacor Hospital, to increase the survival of children with Burkitt Lymphoma (BL), in line with WHO initiative.

Methods

Developed through multi-stakeholders participatory methodologies, ABLE+ pursues a holistic and integrated approach to fill gaps in the different phases of care, focusing on children and their caregivers.

ABLE+ reinforces hospitals’ and health centers’ doctors’ and health workers’ capacities; supports them through supervision with mobile technologies to improve early detection and diagnosis; strengthens the referral system to facilitate access to care; provides psychosocial and educational support to children, increases caregivers' awareness and empowerment, also through income generating activities; enhances the sustainability of care through follow-up and home visits.

Results

In spite of COVID-19 pandemic disruptions, 143 new BL cases were referred in 4 years (36 cases/year against 17 in 2016), with 0% treatment abandonment in the last 2 years and the mortality rate of children treated for BL decreased from 47.05% (2016) to 28.95% (2021).

Conclusions

An innovative, integrated, holistic and cost-effective intervention with high potential social impact should be considered for scaling-up and/or replication in other LMIC.

Background and Aims

BACKGROUND

The situation of childhood cancer is alarmingly in sub-Saharan countries where the cure rate does not exceed 15 to 20 %. This is due to insufficient means of diagnosis, to the delay of treatment and especially to the lack of adapted chemotherapy protocols.

The delay in diagnosis is based on a complex chain of factors and events complicated by the difficulties. Early diagnosis is a fundamental objective in oncology.

AIM

The main aim is to evaluate the knowledge and attitudes of medical and paramedical personnel in the early diagnosis of childhood cancer in the health district of Sikasso.

Methods

METHOD :

This is a prospective, descriptive, cross-sectional study conducted over 6 months in 2021 on a sample of 120 community health workers. Data collection was carried out using a previously tested structured questionnaire.

Results

RESULTS

We interviewed 120 health workers and noted that 36.67% were general practitioners, 29.17% were nurses, 5.83% were pediatricians, 10.8% were midwives, and 17.5% were from other specialties. According to them, the first signs of cancer were adenopathy (90.8%), abdominal mass (89.2%), hepatosplenomegaly (75.8%) and 75.8% stated that there was a predisposition to cancer in children. In front of an abdominal mass 51.6% requested an abdominal ultrasound. 92.5% of the agents thought that management depended on early diagnosis.

Conclusions

CONCLUSION

The lack of knowledge of the early signs of cancer leads to delayed diagnosis.

Background and Aims

Proyecto EVAT (Escala de Valoración de Alerta Temprana) is a quality improvement collaborative with 73 pediatric oncology centers in 19 countries in Latin American and Europe to reduce clinical deterioration in children with cancer through implementation of a Spanish-language Pediatric Early Warning System (PEWS). Recently, how to explain EVAT to families is a common question among new centers. Therefore, we describe the development of a formal processes to guide hospital staff in how to communicate to the parent about EVAT.

Methods

This project included three phases. First, EVAT implementation leaders were surveyed on strategies of how they teach EVAT to parents. Subsequently, this exploration was discussed with the EVAT steering committee – wich is composed of 27 member leadership of Proyecto EVAT, made of a multidisciplinary team of experts from Latin America-, to create a manual to describe best practices for how to teach families on EVAT. This was supplemented with visual material to reinforce major topics during training. Finally, the impact of this new training will be measured through satisfaction surveys of hospital staff.

Results

Surveys of EVAT implementation leaders from 38 centers found that most centers teach EVAT to families with the material provided through Proyecto EVAT for teaching hospital staff, including the PEWS scale, algorithm, and a blackboard that shows the traffic light (color status of a patient); only one center used specialized material developed specifically for families to carry out this training. To standardize those who do not use specific materials, a triptych, an infographic and a video are developing to help centers to communicate EVAT to families.

Conclusions

While teaching EVAT to families is a universal need, few standardized resources for this exist. Creating of EVAT educational best practices aimed specifically at families will improve communication between hospital staff and families and improve hospital care.