scholarly journals Establishing a Pediatric Hematology-Oncology Program in Botswana

2018 ◽  
pp. 1-9 ◽  
Author(s):  
Jeremy S. Slone ◽  
Amanda K. Slone ◽  
Oaitse Wally ◽  
Pearl Semetsa ◽  
Mpho Raletshegwana ◽  
...  
Keyword(s):  
Pediatric Cancer ◽  
Patient Characteristics ◽  
Baylor College ◽  
Blood Disorders ◽  
Middle Income ◽  
Children's Hospital ◽  
Pediatric Hematology ◽  
Middle Income Countries ◽  
Histopathologic Diagnosis ◽  
Children’S Hospital

Purpose Annually, 300,000 children are diagnosed with cancer, and the majority of these children live in low- and middle-income countries (LMICs). Currently, there is incomplete information on pediatric cancer incidence, diagnosis distribution, and treatment outcomes in Africa. Since 2007, a pediatric hematology-oncology program has been operating in Botswana through a partnership between the Botswana government, Baylor College of Medicine, and Texas Children’s Hospital. Methods To better understand patient characteristics and outcomes at Botswana’s only pediatric cancer program, a hospital-based data base—the Botswana Pediatric Oncology Database—was established in 2014. Children younger than 18 years of age at the time of diagnosis who presented between 2008 and 2015 were included. Data for this study were extracted in February 2016. Results Of the 240 potential enrollees, 185 (77%) children met eligibility for this study. The median age was 6.4 years, and 50.8% were male. Leukemia was the most common malignancy representing 18.9% of the cohort and 88.1% of the total cohort had a histopathologic diagnosis. HIV seropositivity was confirmed in 13.5%. The 2-year overall survival of all pediatric cancer diagnoses was 52.4%. Abandonment of treatment occurred in 3.8% of patients. Conclusion In the first 9 years of the program, capacity has been developed through a longstanding partnership between Botswana and Baylor College of Medicine/Texas Children’s Hospital that has led to children receiving care for cancer and blood disorders. Although continued improvements are necessary, outcomes to date indicate that children with cancer in Botswana can be successfully diagnosed and treated.

Socio-Economic Challenges in Childhood Cancer Care in a Low-Middle-Income Country

2021 ◽  
Vol 15 (6) ◽  
pp. 1234-1236
Author(s):  
A. Ahmad ◽  
A. Anjum ◽  
M. Hussain ◽  
A. A. Rasul ◽  
A. Mushtaq ◽  
...  
Keyword(s):  
Childhood Cancer ◽  
Treatment Center ◽  
P Value ◽  
Psychosocial Needs ◽  
Middle Income ◽  
Female Ratio ◽  
Children's Hospital ◽  
Middle Income Countries ◽  
Low Middle Income Countries ◽  
Children’S Hospital

Background: Each year, it is estimated that over 200 000 children and adolescents are diagnosed with cancer, and 80% of these reside in low-middle-income countries, with 90% mortality. There are enormous psychosocial needs of these patients, families, and care-givers, which are primarily affected by the communities' social, economic, cultural, and religious factors. Aim: To elucidate the significant psychosocial and socio-economic issues faced by the caregivers of children suffering from different types of cancer at the Children's Hospital Lahore. Study design: Prospective cohort study Place and duration of study: Department of Paediatric Hematology and Oncology, Children's Hospital Lahore Pakistan from 1st January 2018 to 30th June 2018 Methodology: Two hundred family members/caregivers of the patients were enrolled with ages ranging from <1 to 15 years (43% <5 years and 57% >5years old). Results: Male to female ratio was 1.2:1. 52% belonged to hematological malignancies and 48% from solid tumor groups. Most of these children had malnutrition with anemia (81% with Hb <10g%) and small weight forage in 63% cases at presentation. 80% of families had more than three children, with the youngest child being less than five years in 75%. 95% of families relied on public transport, with 65% of them traveling 100-500Km with 2-10 hours duration to reach the primary treatment center. 80% had a monthly income of less than USD150. 68% of these families had to borrow money for trip to hospital (p-Value=0.003), and 58% took a loan for treatment course. Conclusion: The significant socio-economic challenges faced by these families and caregivers included large family size with low incomes increasing their financial difficulties, logistic burden like traveling long distances to access health care, and parental employment and family dynamics disruptions. Keywords: Socioeconomic Challenges, Childhood Cancer, Low-Middle-Income Countries

Pediatric cancer communication in low‐ and middle‐income countries: A scoping review

Cancer ◽  
2020 ◽  
Vol 126 (23) ◽  
pp. 5030-5039
Author(s):  
Dylan E. Graetz ◽  
Marcela Garza ◽  
Carlos Rodriguez‐Galindo ◽  
Jennifer W. Mack
Keyword(s):  
Scoping Review ◽  
Pediatric Cancer ◽  
Cancer Communication ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low And Middle Income

Initiation of family-centered bedside rounds at Phoenix Children's Hospital Center for Cancer and Blood Disorders.

2018 ◽  
Vol 36 (30_suppl) ◽  
pp. 170-170
Author(s):  
Cathy A Lee-Miller ◽  
Renee Connor ◽  
Lynnette Acosta ◽  
Cynthia Wetmore
Keyword(s):  
Patient Safety ◽  
Patient Satisfaction ◽  
Real Time ◽  
Nurse Practitioners ◽  
Employee Satisfaction ◽  
Time Range ◽  
Blood Disorders ◽  
Children's Hospital ◽  
Children’S Hospital ◽  
Family Centered

170 Background: There has been a national trend towards a family/patient-centered care model in an effort to achieve many goals: earlier discharges, enhanced collaboration and patient safety, and improved satisfaction among medical care teams, patients and families. While most of the services at Phoenix Children’s Hospital (PCH) utilized a family-centered rounding model, the hematology/oncology service used table rounds. In December 2017, the Center for Cancer and Blood Disorders (CCBD) initiated family-centered rounds (FCR) on the inpatient service. Methods: FCR participants include patient, parent(s), bedside nurse, clinical supervisor, residents, fellow, attending, nurse practitioners, pharmacist, dietitian and child life specialist. One unique aspect of our FCR model is using scheduled rounds, whereby each patient is allotted a specific length of time and each family is given a time range within which to expect the team. Patients are scheduled every 10 minutes and if more time is needed, the attending/fellow return later for discussion. Staying on a schedule allows for improved nursing workflow and for consulting teams and interpreters to join rounds for specific patients. Outcome measures include patient, family and employee satisfaction. Results: Patient satisfaction is measured using NRC Real-time electronic survey. Scores have increased from a baseline of 70% (Oct/Nov 2017) to 87.5% (April 2018) after the initiation of FCR. From a qualitative standpoint, families have expressed gratitude for the new rounding model. Staff have expressed increased satisfaction at the efficiency and thoroughness of communication on rounds and the multidisciplinary team allows for real-time collaboration. Conclusions: FCR have led to increases in patient satisfaction both quantitatively and qualitatively. Ongoing initiatives include adding family-centered night rounds and a more extensive evaluation of FCR’s impact on employee satisfaction, patient safety, length of stay and lower overall costs. We are continuously evaluating the structure and efficacy of FCR to achieve the best possible care for our patients.

Bloodstream Infections in Pediatric Oncology Outpatients: A New Healthcare Systems Challenge

2002 ◽  
Vol 23 (5) ◽  
pp. 239-243 ◽  
Author(s):  
Theresa L. Smith ◽  
Gregg T. Pullen ◽  
Vonda Crouse ◽  
Jon Rosenberg ◽  
William R. Jarvis
Keyword(s):  
Bloodstream Infections ◽  
Venous Catheter ◽  
Case Patient ◽  
Gram Negative ◽  
Children's Hospital ◽  
Pediatric Hematology ◽  
Patient Demographics ◽  
Children’S Hospital ◽  
And Control ◽  
Control Study

Objective:To investigate a perceived increase in central venous catheter (CVC)–associated bloodstream infections (BSIs) among pediatric hematology–oncology outpatients.Design:A case–control study.Setting:A pediatric hematology–oncology outpatient clinic at Fresno Children's Hospital.Patients:Pediatric hematology–oncology clinic outpatients with CVCs at Fresno Children's Hospital between November 1994 and October 1997.Methods:A case-patient was defined as any hematology–oncology outpatient with a CVC-associated BSI at Fresno Children's Hospital from November 1996 to October 1997 (study period) without a localizable infection. To identify case-patients, we reviewed Fresno Children's Hospital records for all hematology–oncology clinic patients, those with CVCs and those with CVCs and BSIs. Control-patients were randomly selected hematology–oncology outpatients with a CVC but no BSI during the study period. Case-patient and control-patient demographics, diagnoses, caretakers, catheter types, catheter care, and water exposure were compared.Results:Twenty-five case-patients had 42 CVC-associated BSIs during the study period. No significant increase in CVC-associated BSI rates occurred among pediatric hematology–oncology patients. However, there was a statistically significant increase in nonendogenous, gram-negative (eg, Pseudomonas species) BSIs during summer months (May–October) compared with the rest of the year. Case-patients and control-patients differed only in catheter type; case-patients were more likely than control-patients to have a transcutaneous CVC. Summertime recreational water exposures were similar and high in the two groups.Conclusions:Hematology–oncology clinic patients with transcutaneous CVCs are at greater risk for CVC-associated BSI, particularly during the summer. Caretakers should be instructed on proper care of CVCs, particularly protection of CVCs during bathing and recreational summer water activities, to reduce the risk of nonendogenous, gram-negative BSIs.

scholarly journals ORAL/ENTERAL NUTRITIONAL SUPPLEMENTATION IN CHILDREN TREATED FOR CANCER IN LOW-MIDDLE-INCOME COUNTRIES IS FEASIBLE AND EFFECTIVE: THE EXPERIENCE OF THE CHILDREN'S HOSPITAL MANUEL DE JESUS RIVERA "LA MASCOTA" IN NICARAGUA.

2018 ◽  
Vol 10 (1) ◽  
pp. e2018038 ◽  
Author(s):  
Nicolò Peccatori ◽  
Roberta Ortiz ◽  
Emanuela Rossi ◽  
Patricia Calderon ◽  
Valentino Conter ◽  
...  
Keyword(s):  
Solid Tumor ◽  
Nutritional Assessment ◽  
Malignant Tumors ◽  
Nutritional Intervention ◽  
Nutritional Supplementation ◽  
Middle Income ◽  
Children's Hospital ◽  
Low Middle Income Countries ◽  
Pediatric Cancer Patients ◽  
Children’S Hospital

Background and objectives. The prevalence of malnutrition in children diagnosed with malignant tumors in Nicaragua has been reported to be 67%. Thus, a nutritional program for children with cancer has been developed at the Children’s Hospital Manuel de Jesus Rivera (Managua, Nicaragua).Methods. A qualified nutritionist evaluated all patients and prescribed oral/enteral supplementation. The nutritional assessment was based on weight, height or length, mid upper arm circumference (MUAC) and triceps skin fold thickness (TSFT). In this descriptive study, pre and post-nutritional intervention data were compared and analyzed in terms of event free survival.Results. 104 patients (median age 7.0 years, 52 with leukemia/lymphoma and 52 with solid tumor) underwent oral/enteral nutritional supplementation; 64 of these patients had pre and post supplementation nutritional assessment. Overall, 55% of patients in the leukemia/lymphoma group and the 35% in the solid tumor group improved their condition or remained in an adequately nourished status.Conclusion. This experience demonstrates that nutritional supplementation in pediatric cancer patients who are inadequately nourished is feasible also in countries with limited resources and is effective in improving the nutritional conditions.

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