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Abandonment of childhood cancer treatment in Western Kenya
  1. F Njuguna1,
  2. S Mostert2,
  3. A Slot2,
  4. S Langat1,
  5. J Skiles3,
  6. M N Sitaresmi4,
  7. P M van de Ven5,
  8. J Musimbi1,
  9. H Muliro1,
  10. R C Vreeman3,
  11. G J L Kaspers2
  1. 1Department of Child Health and Pediatrics, Moi Teaching and Referral Hospital, Eldoret, Kenya
  2. 2Department of Pediatric Oncology-Hematology and Doctor 2 Doctor program, VU University Medical Center, Amsterdam, The Netherlands
  3. 3Department of Pediatrics and USAID-Academic Model Providing Access to Healthcare (AMPATH) program, Indiana University School of Medicine, Indianapolis, USA
  4. 4Department of Pediatrics, Dr Sardjito Hospital, Yogyakarta, Indonesia
  5. 5Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, The Netherlands
  1. Correspondence to Dr Festus Njuguna, Department of Child Health and Pediatrics, Moi Teaching and Referral Hospital, P.O Box 3, Eldoret 30100, Kenya; muigaifes2000{at}yahoo.com

Abstract

Background The most important reason for childhood cancer treatment failure in low-income countries is treatment abandonment.

Objective The aim of this study was to explore reasons for childhood cancer treatment abandonment and assess the clinical condition of these children.

Design This was a descriptive study using semistructured questionnaires. Home visits were conducted to interview families of childhood cancer patients, diagnosed between January 2007 and January 2009, who had abandoned treatment at the Moi Teaching and Referral Hospital (MTRH).

Results Between January 2007 and January 2009, 222 children were newly diagnosed with a malignancy at MTRH. Treatment outcome was documented in 180 patients. Of these 180 patients, 98 (54%) children abandoned treatment. From December 2011 until August 2012, 53 (54%) of the 98 families were contacted. Due to lack of contact information, 45 families were untraceable. From 53 contacted families, 46 (87%) families agreed to be interviewed. Reasons for abandonment were reported by 26 families, and they were diverse. Most common reasons were financial difficulties (46%), inadequate access to health insurance (27%) and transportation difficulties (23%). Most patients (72%) abandoned treatment after the first 3 months had been completed. Of the 46 children who abandoned treatment, 9 (20%) were still alive: 6 (67%) of these children looked healthy and 3 (33%) ill. The remaining 37 (80%) children had passed away.

Conclusions Prevention of childhood cancer treatment abandonment requires improved access to health insurance, financial or transportation support, proper parental education, psychosocial guidance and ameliorated communication skills of healthcare providers.

  • childhood cancer
  • treatment abandonment

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