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Semerci R, Savaş EH, Uysal G, Alki K. The predictive power of coping strategies of pediatric oncology patients on their quality of life and their attitudes toward diseases. Pediatr Blood Cancer 2024; 71:e31196. [PMID: 39039618 DOI: 10.1002/pbc.31196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2024] [Accepted: 07/01/2024] [Indexed: 07/24/2024]
Abstract
BACKGROUND/OBJECTIVES Pediatric oncology patients face several physical and psychological challenges that can significantly impact their quality of life (QoL) and attitudes toward their illness. Coping strategies are pivotal in managing the emotional and physical burdens of disease. This study aimed to examine the impact of coping strategies of pediatric oncology patients on their QoL and attitudes towards their illness. DESIGN/METHODS The descriptive, correlational, and cross-sectional study was conducted with 112 pediatric oncology patients aged 10-18 years. The Sociodemographic Form, Pediatric Cancer Coping Scale (PCCS), Pediatric Quality of Life Inventory (PedsQL), and Child Attitude Towards Illness Scale (CATIS) were used for data collection. RESULTS Significant correlations were identified between cognitive coping, defensive coping, and CATIS (p < .001). The PCCS and subdimensions significantly predicted CATIS (p < .001), accounting for 15.3% of the cognitive and defensive coping variation. However, there was no relationship between PCCS total and subdimension scores on PedsQL (p = .534). The PedsQL and subdimensions significantly predicted CATIS (p < .001) and accounted for 27.2% of the variation in physical health summary score, emotional functioning, psychosocial health summary score, and total PedsQL score. CONCLUSION The study reveals that cognitive coping strategies positively predict attitudes toward illness, whereas defensive coping strategies have an inverse effect. The study proposes that comprehensive care models in pediatric oncology support effective coping mechanisms and enhance the QoL of those who receive them.
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Affiliation(s)
- Remziye Semerci
- School of Nursing, Department of Pediatric Nursing, Koç University, İstanbul, Turkey
| | - Eysan Hanzade Savaş
- School of Nursing, Department of Pediatric Nursing, Koç University, İstanbul, Turkey
| | - Gülzade Uysal
- Faculty of Health Sciences, Department of Nursing, Sakarya University of Applied Sciences, Sakarya, Turkey
| | - Kübra Alki
- Department of Pediatric Bone Marrow Transplantation Unit, Başakşehir Çam and Sakura State Hospital, İstanbul, Turkey
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Carson L, Petricca K, Denburg A. The promise of POSIT: Real-world application of the Paediatric Oncology System Integration Tool. J Cancer Policy 2024; 39:100454. [PMID: 37989453 DOI: 10.1016/j.jcpo.2023.100454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Revised: 10/14/2023] [Accepted: 11/13/2023] [Indexed: 11/23/2023]
Abstract
Childhood cancer presents significant acute and long-term challenges for patients,families, communities, and health systems. Although meaningful strides have been made in research and treatment, severe outcome disparities prevail between low- and middle-income countries (LMICs) and high-income countries (HICs), with childhood cancer survival rates lower than 20% in LMICs, as compared with over 80% across many HICs. In recent years, greater emphasis has been placed on health system strengthening as a means to develop domestic policy and capacity for sustainable improvements in childhood cancer outcomes in LMICs. In pursuit of a systems approach to childhood cancer in LMICs, our research team developed the Paediatric Oncology System Integration Tool (POSIT)-the first comprehensive framework for the design and evaluation of childhood cancer systems. Since its development, POSIT has been applied in an exploration of key determinants of access to essential childhood cancer medicines across two separate multi-site studies. In this commentary, we explore the value of the POSIT framework and toolkit as a constructive systems-level guide for examining interactions between childhood cancer-specific programs and encompassing health system. socio-political, and economic contexts.
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Affiliation(s)
- Laura Carson
- Peter Gilgan Centre for Research and Learning, The Hospital for Sick Children, Toronto, ON, Canada
| | - Kadia Petricca
- Peter Gilgan Centre for Research and Learning, The Hospital for Sick Children, Toronto, ON, Canada
| | - Avram Denburg
- Department of Paediatrics, Faculty of Medicine, University of Toronto, Toronto, ON, Canada; Division of Haematology/Oncology, The Hospital for Sick Children, Toronto, ON, Canada.
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Challinor J, Davidson A, Chantada G, Kebudi R, Pritchard-Jones K. The role of International Society of Paediatric Oncology (SIOP) in advancing global childhood cancer care. Ecancermedicalscience 2024; 18:1678. [PMID: 38439802 PMCID: PMC10911668 DOI: 10.3332/ecancer.2024.1678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Indexed: 03/06/2024] Open
Abstract
The Société Internationale d'Oncologie Pédiatrique [International Society of Paediatric Oncology] (SIOP), founded in 1969, aims to improve the lives of children and adolescents with cancer through global collaboration, education, training, research and advocacy. The annual congress provides the opportunity to share late-breaking research, clinical experiences and debate, with experts worldwide. SIOP's six Continental Branches represent their constituent members in North America, Oceania, Latin America, Africa, Europe and Asia and bring best practices and recent research findings of value to their specific patient populations. In 1990, the SIOP Board of Directors addressed the formerly predominantly European/North American society transforming into a global association by establishing a scholarship program to bring low- and middle-income country (LMIC) paediatric oncologists and nurses to SIOP meetings. A major achievement was SIOP's acceptance as a World Health Organisation (WHO) non-state actor in official relations in 2018, joining 220 non-governmental organisations, international business associations and philanthropic foundations with this privilege. SIOP supports advocacy with WHO member states and civil society to highlight the specific needs of cancer in this age-group through key programs especially supporting the WHO Global Initiative for Childhood Cancer. Sustained improvement in childhood cancer outcomes has paralleled the integration of research with care; thus, SIOP launched a Programme for Advancing Research Capacity for funding selected clinical trial groups in LMICs. SIOP supports south-south partnerships, and the principles elegantly expressed in SIOP Africa's checklist for co-branding projects, that include the prioritisation of local needs, cultivation of local expertise and commitment to equitable partnerships. SIOP now counts approximately 3,000 members from over 128 countries; 39% are from more than 60 LMICs. SIOP members have multidisciplinary expertise on all aspects of childhood cancer care working in collaboration with key stakeholders including governments, civil society organisations and funders to improve the lives of children/adolescents with cancer everywhere in all ways.
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Affiliation(s)
- Julia Challinor
- School of Nursing, University of California San Francisco, 2 Koret Way, San Francisco, CA 94143, USA
- https://orcid.org/0000-0002-5008-8501
| | - Alan Davidson
- Pediatric Hematology-Oncology Service, Red Cross War Memorial Children’s Hospital, University of Cape Town, Rondebosch, Cape Town 7700, South Africa
- https://orcid.org/0000-0002-4646-4332
| | - Guillermo Chantada
- Department of Pediatric Oncology, Hospital Sant Joan de Deu, Pg de Sant Joan de Déu, 2, Esplugues de Llobregat, 08950 Barcelona, Spain
- Departamento de Montevideo, Fundación Perez Scremini, Bv Gral Artigas 1556, Montevideo 11600, Uruguay
- https://orcid.org/0000-0002-9375-9336
| | - Rejin Kebudi
- Division of Pediatric Hematology-Oncology, Department of Clinical Oncology, Oncology Institute, Topkapı, Turgut Özal Millet Cd No:118, 34093 Fatih/Istanbul, Turkey
- Division of Pediatric Hematology-Oncology, Department of Preventive Oncology, Oncology Institute, Topkapı, Turgut Özal Millet Cd No:118, 34093 Fatih/Istanbul, Turkey
- https://orcid.org/0000-0003-4344-8174
| | - Kathy Pritchard-Jones
- University College London Great Ormond Street Institute of Child Health, 30 Guilford St, WC1N 1EH London, UK
- https://orcid.org/0000-0002-2384-9475
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Shallal A, Jarrah J, Prentiss T, Suleyman G, Veve MP, Banat A, Zervos J, Mousa AB, Msadeh L, Zerriouh Thneibat FM, Zervos M, Al-Raiby J, Alsawalha L, Zayed B. Lessons from the field: Supporting infection prevention and control and antimicrobial stewardship in Amman, Jordan. J Infect Public Health 2023; 16 Suppl 1:78-81. [PMID: 37945495 DOI: 10.1016/j.jiph.2023.10.044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Revised: 10/28/2023] [Accepted: 10/30/2023] [Indexed: 11/12/2023] Open
Abstract
BACKGROUND To reduce antimicrobial resistance (AMR), appropriate antimicrobial prescribing is critical. In conjunction with Infection Prevention & Control (IPC) programs, Antimicrobial Stewardship Programs (ASP) have been shown to improve prescribing practices and patient outcomes. Low- and middle-income countries (LMIC) face challenges related to inadequate ASP policies and guidelines at both the national and healthcare facility (HCF) levels. METHODS To address this challenge, the World Health Organization (WHO) created a policy guidance and practical toolkit for implementation of ASPs in LMIC. We utilized this document to support a situational analysis and two-day ASP-focused workshop. In follow-up, we invited these attendees, additional HCF and hospital directors to attend a workshop focused on the benefits of supporting these programs. RESULTS Over the course of a total three days, we recruited hospital directors, ASP team members, and IPC officers from fifteen different healthcare facilities in Jordan. We describe the courses and coordination, feedback from participants, and lessons learned for future implementation. CONCLUSIONS Future efforts will include more time for panel-type discussion. which will assist in further delineating enablers and barriers. Also planned is a total three-day workshop; with the first two days being with ASP/IPC teams, and the final third day being with hospital directors and leadership. The WHO policy guidance and toolkit are useful tools to address overuse of antimicrobial agents. Strong leadership support is needed for successful implementation of ASP and IPC. Discussions on quality/safety, as well as cost analyses, are important to generate interest of stakeholders.
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Affiliation(s)
- Anita Shallal
- Henry Ford Hospital, 2799 W Grand Blvd, Detroit, MI 48202, USA.
| | - Joud Jarrah
- King Hussein Cancer Center, P.O.Box 1269 Al-Jubeiha, Amman 11941, Jordan
| | - Tyler Prentiss
- Global Health Initiative, 1 Ford Place, Detroit, MI 48202, USA
| | - Geehan Suleyman
- Henry Ford Hospital, 2799 W Grand Blvd, Detroit, MI 48202, USA
| | - Michael P Veve
- Henry Ford Hospital, 2799 W Grand Blvd, Detroit, MI 48202, USA; Department of Pharmacy Practice, Eugene Applebaum College of Pharmacy and Health Sciences, Wayne State University, Detroit, MI, USA
| | - Ayat Banat
- Ministry of Health, ALhashimi Alshamaly, P.O.Box 86, Amman 11118, Jordan
| | - John Zervos
- Global Health Initiative, 1 Ford Place, Detroit, MI 48202, USA
| | - Ayman Bani Mousa
- Ministry of Health, ALhashimi Alshamaly, P.O.Box 86, Amman 11118, Jordan
| | - Lama Msadeh
- Ministry of Health, ALhashimi Alshamaly, P.O.Box 86, Amman 11118, Jordan
| | | | - Marcus Zervos
- Henry Ford Hospital, 2799 W Grand Blvd, Detroit, MI 48202, USA
| | - Jamela Al-Raiby
- WHO Jordan Country Office, Ministry of Interior Circle, Mohammad Jamjoum Street, PO Box 811547, Amman 11181, Jordan
| | - Lora Alsawalha
- WHO Jordan Country Office, Ministry of Interior Circle, Mohammad Jamjoum Street, PO Box 811547, Amman 11181, Jordan
| | - Bassim Zayed
- WHO Jordan Country Office, Ministry of Interior Circle, Mohammad Jamjoum Street, PO Box 811547, Amman 11181, Jordan
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Damasco-Avila E, Zelaya Sagastizado S, Carrillo M, Blanco J, Fu L, Espinoza D, Ladas EJ. Improving the Quality of the Delivery of Nutritional Care Among Children Undergoing Treatment for Cancer in a Low- and Middle-Income Country. JCO Glob Oncol 2023; 9:e2300074. [PMID: 37384860 PMCID: PMC10497261 DOI: 10.1200/go.23.00074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 05/01/2023] [Accepted: 05/19/2023] [Indexed: 07/01/2023] Open
Abstract
PURPOSE International twinning programs have been well-established between institutions in childhood cancer and have led to pediatric cancer units in low- and middle-income countries (LMICs) adopting multidisciplinary forms of care. To advance nutritional care in LMICs, the International Initiative for Pediatrics and Nutrition (IIPAN) provided the structural framework and personnel for the delivery of nutritional care. We describe the impact of a newly established nutrition program on the delivery of nutritional care and nutrition-related clinical outcomes in children and adolescents undergoing treatment for cancer in Nicaragua and Honduras. METHODS A prospective cohort (N = 126) collected clinical data over a 2-year period. Collection of IIPAN's nutritional services received during treatment and clinical data were abstracted from medical charts and registered in Research Electronic Data Capture (REDCap) database. Chi-square, ANOVA, and generalized linear mixed models were used; P < .05 was considered statistically significant. RESULTS Nutritional assessments led to a higher number of patients receiving recommended standard of care. Children classified as underweight during treatment presented higher number of infections and toxicities, length of hospital stay, and days of treatment delays during treatment. Overall, from the start to end of treatment, 32.5% of patients improved nutritional status, 35.7% maintained it, and 17.5% worsened. On the basis of metrics, the cost per consultation was less than 4.80 US dollars (USD; Honduras) and 1.60 USD (Nicaragua). CONCLUSION Integration and equitable access of the nutritional care process for all patients needs to be recognized as a component of the basic management in pediatric oncology care. IIPAN's nutritional program demonstrates that nutritional care is economical and feasible in a limited resource setting.
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Affiliation(s)
- Erika Damasco-Avila
- Division of Pediatric Hematology/Oncology/Stem Cell Transplant, Columbia University Irving Medical Center, New York, NY
| | | | - María Carrillo
- Department of Hematology/Oncology, Hospital Infantil Manuel de Jesús Rivera, Managua, Nicaragua
| | - Jessica Blanco
- National Unit of Pediatric Oncology, Guatemala City, Guatemala
| | - Ligia Fu
- Pediatric Hematology and Oncology Unit, Hospital Escuela, Tegucigalpa, Honduras
| | - Darrell Espinoza
- Department of Hematology/Oncology, Hospital Infantil Manuel de Jesús Rivera, Managua, Nicaragua
| | - Elena J. Ladas
- Division of Pediatric Hematology/Oncology/Stem Cell Transplant, Columbia University Irving Medical Center, New York, NY
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6
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Bailey S, Davidson A, Parkes J, Tabori U, Figaji A, Epari S, Chinnaswamy G, Dias-Coronado R, Casavilca-Zambrano S, Amayiri N, Vassal G, Bouffet E, Clifford SC. How Can Genomic Innovations in Pediatric Brain Tumors Transform Outcomes in Low- and Middle-Income Countries? JCO Glob Oncol 2022; 8:e2200156. [PMID: 36252166 PMCID: PMC9812475 DOI: 10.1200/go.22.00156] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Pragmatic ways to apply molecular innovation to childhood brain cancer diagnosis and therapy in LMICs![]()
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Affiliation(s)
- Simon Bailey
- Great North Children's Hospital and Newcastle University, Newcastle upon Tyne, United Kingdom,Simon Bailey, MBChB, PhD, Sir James Spence Institute of Child Health, Royal Victoria Infirmary, Queen Victoria Rd, Newcastle upon Tyne NE1 4LP, United Kingdom;
| | - Alan Davidson
- Haematology Oncology Service, Red Cross War Memorial Children's Hospital, Department of Paediatrics and Child Health, University of Cape Town, Cape Town, South Africa
| | - Jeannette Parkes
- Department of Radiation Oncology, Groote Schuur Hospital and University of Cape Town, Cape Town, South Africa
| | - Uri Tabori
- Neuro-oncology Program, Division of Haematology/Oncology, The Hospital for Sick Children, Toronto, ON, Canada
| | - Anthony Figaji
- Department of Neurosurgery, Red Cross War Memorial Children's Hospital and University of Cape Town, Cape Town, South Africa
| | - Shridar Epari
- Department of Pathology, ACTREC and Tata Memorial Hospital, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
| | - Girish Chinnaswamy
- Department of Pediatric Oncology, Tata Memorial Hospital, Parel, Mumbai, India
| | - Rosaldi Dias-Coronado
- Pediatric Oncology Department—Instituto Nacional de Enfermedades Neoplásicas, Surquillo, Peru
| | - Sandro Casavilca-Zambrano
- Instituto Nacional de Enfermedades Neoplásicas, Lima, Perú and Facultad de Ciencias de la Salud de La Universidad de Huánuco, Huánuco, Peru
| | - Nisreen Amayiri
- Department of Hematology and Oncology, King Hussein Cancer Centre, Amman, Jordan
| | - Gilles Vassal
- Department of Pediatric and Adolescent Oncology, Institut Gustave-Roussy, Villejuif, France
| | - Eric Bouffet
- Neuro-oncology Program, Division of Haematology/Oncology, The Hospital for Sick Children, Toronto, ON, Canada
| | - Steven C. Clifford
- Wolfson Childhood Cancer Research Centre, Newcastle University Centre for Cancer, Newcastle upon Tyne, United Kingdom
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Haier J, Schaefers J. Economic Perspective of Cancer Care and Its Consequences for Vulnerable Groups. Cancers (Basel) 2022; 14:cancers14133158. [PMID: 35804928 PMCID: PMC9265013 DOI: 10.3390/cancers14133158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 05/04/2022] [Accepted: 06/15/2022] [Indexed: 12/02/2022] Open
Abstract
Simple Summary For cancer patients, many different reasons can cause financial burdens and economic threads. Sociodemographic factors, rural/remote location and income are known determinants for these vulnerable groups. This economic vulnerability is related to the reduced utilization of cancer care and the impact on outcome. Financial burden has been reported in many countries throughout the world and needs to be addressed as part of the sufficient quality of cancer care. Abstract Within healthcare systems in all countries, vulnerable groups of patients can be identified and are characterized by the reduced utilization of available healthcare. Many different reasons can be attributed to this observation, summarized as implementation barriers involving acceptance, accessibility, affordability, acceptability and quality of care. For many patients, cancer care is specifically associated with the occurrence of vulnerability due to the complex disease, very different target groups and delivery situations (from prevention to palliative care) as well as cost-intensive care. Sociodemographic factors, such as educational level, rural/remote location and income, are known determinants for these vulnerable groups. However, different forms of financial burdens likely influence this vulnerability in cancer care delivery in a distinct manner. In a narrative review, these socioeconomic challenges are summarized regarding their occurrence and consequences to current cancer care. Overall, besides direct costs such as for treatment, many facets of indirect costs including survivorship costs for the cancer patients and their social environment need to be considered regarding the impact on vulnerability, treatment compliance and abundance. In addition, individual cancer-related financial burden might also affect the society due to the loss of productivity and workforce availability. Healthcare providers are requested to address this vulnerability during the treatment of cancer patients.
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Major A, Palese M, Ermis E, James A, Villarroel M, Klussmann FA, Hessissen L, Geel J, Khan MS, Dalvi R, Sullivan M, Kearns P, Frazier AL, Pritchard-Jones K, Nakagawara A, Rodriguez-Galindo C, Volchenboum SL. Mapping Pediatric Oncology Clinical Trial Collaborative Groups on the Global Stage. JCO Glob Oncol 2022; 8:e2100266. [PMID: 35157510 PMCID: PMC8853619 DOI: 10.1200/go.21.00266] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
The global pediatric oncology clinical research landscape, particularly in Central and South America, Africa, and Asia, which bear the highest burden of global childhood cancer cases, is less characterized in the literature. Review of how existing pediatric cancer clinical trial groups internationally have been formed and how their research goals have been pursued is critical for building global collaborative research and data-sharing efforts, in line with the WHO Global Initiative for Childhood Cancer. Local stakeholder engagement is necessary to collaborate with global pediatric cancer trial groups.![]()
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Affiliation(s)
- Ajay Major
- Department of Medicine, Section of Hematology/Oncology, University of Chicago, Chicago, IL
| | - Monica Palese
- Department of Pediatrics, University of Chicago, Chicago, IL
| | - Ebru Ermis
- Department of Pediatrics, University of Chicago, Chicago, IL
| | - Anthony James
- Department of Pediatrics, University of Chicago, Chicago, IL
| | - Milena Villarroel
- Grupo de América Latina de Oncología Pediátrica (GALOP), Hospital Luis Calvo Mackenna, National Pediatric Cancer Program (PINDA), Santiago, Chile
| | - Federico Antillon Klussmann
- National Unit of Pediatric Oncology, Francisco Marroquin University School of Medicine, Guatemala City, Guatemala
| | - Laila Hessissen
- Pediatric Hematology and Oncology, Mohammed V University of Rabat, Rabat, Morocco
| | - Jennifer Geel
- Faculty of Health Sciences, Division of Pediatric Haematology and Oncology, Department of Pediatrics and Child Health, University of the Witwatersrand, Charlotte Maxeke Johannesburg Academic Hospital, Johannesburg, South Africa
| | - Muhammad Saghir Khan
- Department of Pediatrics, King Faisal Specialist Hospital and Research Center, Al Madinah, Saudi Arabia
| | - Rashmi Dalvi
- Bombay Hospital Institute of Medical Sciences and SRCC Children's Hospital, Mumbai, India
| | - Michael Sullivan
- Children's Cancer Centre, Royal Children's Hospital, Melbourne, Australia
| | - Pamela Kearns
- Cancer Research UK Clinical Trials Unit, National Institute for Health Research (NIHR) Birmingham Biomedical Research Centre, Institute of Cancer and Genomic Sciences, Birmingham, United Kingdom
| | | | - Kathy Pritchard-Jones
- UCL Great Ormond Street Institute of Child Health, University College London, London, United Kingdom
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Hopp AM, Tetzlaff JE, Kopidlansky K, Leventaki V, Parsons LN, Bone K, Drendel HM, Sreynich K, Lyvannak S, Heng S, Chanpheaktra N, Putchhat H, Khauv P, Camitta BM, Jarzembowski JA. It Takes a Village. Am J Clin Pathol 2022; 158:81-95. [PMID: 35050350 DOI: 10.1093/ajcp/aqab220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Accepted: 12/20/2021] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES Partnerships between low- to middle-income countries (LMICs) and high-income countries (HICs) is one strategy to mitigate observed health disparities. Cambodia's Angkor Hospital for Children (AHC), an LMIC institution, faces shortages in health care resources, including pathology services. A partnership was created with Children's Wisconsin (CW), an HIC hospital, including provision of pathology services. We describe our established pathology workflow, examine cases seen in AHC patients, and evaluate the impact of CW's interpretations. METHODS AHC provides clinical history and impression and ships samples to CW, which processes the samples, and pathologists provide interpretations, sending reports electronically to AHC. For analysis, final diagnoses were considered "concordant," "refined," or "discordant" based on agreement with the clinical impression. Cases were also classified as "did not change management" or "changed management" based on how CW interpretation affected clinical management. RESULTS We included 347 specimens (177 malignant, 146 benign, 24 insufficient for diagnosis). Of these cases, 31% were discordant and 44% of cases with clinical follow-up had a change in management with CW interpretation. CONCLUSIONS Inclusion of pathology services in LMIC-HIC partnerships is crucial for resolving health disparities between the institutions involved. The described partnership and established pathology workflow can be adapted to the needs and resources of many institutions.
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Affiliation(s)
- Amanda M Hopp
- Department of Pathology, Children’s Wisconsin, Milwaukee, WI, USA
- Department of Pathology, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Julie E Tetzlaff
- Department of Pathology, Children’s Wisconsin, Milwaukee, WI, USA
- Department of Pathology, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Kyle Kopidlansky
- Department of Pathology, Children’s Wisconsin, Milwaukee, WI, USA
| | - Vasiliki Leventaki
- Department of Pathology, Children’s Wisconsin, Milwaukee, WI, USA
- Department of Pathology, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Lauren N Parsons
- Department of Pathology, Children’s Wisconsin, Milwaukee, WI, USA
- Department of Pathology, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Kathleen Bone
- Department of Pathology, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Holli M Drendel
- Department of Pathology, Medical College of Wisconsin, Milwaukee, WI, USA
| | | | - Sam Lyvannak
- Angkor Hospital for Children, Siem Reap, Cambodia
| | - Sing Heng
- Angkor Hospital for Children, Siem Reap, Cambodia
| | | | | | - Phara Khauv
- Angkor Hospital for Children, Siem Reap, Cambodia
| | - Bruce M Camitta
- Department of Hematology, Oncology, and Blood and Marrow Transplant, Children’s Wisconsin, Milwaukee, WI, USA
| | - Jason A Jarzembowski
- Department of Pathology, Children’s Wisconsin, Milwaukee, WI, USA
- Department of Pathology, Medical College of Wisconsin, Milwaukee, WI, USA
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10
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Mills D, Abushanab S, Elhaloul A, El Nuweiry H, Shbair M, Qaddoumi I, Salman Z. Barriers to Care and Outcomes of Pediatric Acute Lymphoblastic Leukemia Treatment in the Gaza Strip. J Pediatr Hematol Oncol 2022; 44:e123-e126. [PMID: 34705357 DOI: 10.1097/mph.0000000000002338] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Accepted: 08/03/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND Childhood acute lymphoblastic leukemia (ALL) is the most common pediatric cancer worldwide. Although children in high-income countries enjoy survival rates of ~90%, children in countries with limited resources suffer from survival rates of <35%. No published data on pediatric cancer incidence, management, or outcomes in the Gaza Strip are available. METHODS A retrospective cohort study was undertaken for pediatric (below 12 y of age) ALL diagnoses admitted to the only pediatric cancer ward in the Gaza Strip between 2010 and 2015. Outcomes included event-free survival (EFS) and overall survival (OS) calculated by Kaplan-Meier estimates. Events were defined as induction failure, relapse, and death. RESULTS The 3-year EFS estimate was 80% (95% confidence interval [CI], 66%-89%). The EFS at 1 and 3 years for high-risk ALL was 55% (95% CI, 27%-76%) and 23% (95% CI, 4%-51%), respectively. The 3-year OS was 93% (95% CI, 82%-97%). The 3-year OS for high-risk ALL was 69% (95% CI, 30%-90%). All 84 (100%) patients required referral to an outside hospital for definitive ALL diagnoses and induction therapy. Forty-four (52%) patients required at least one additional referral. CONCLUSIONS The overall outcomes demonstrated relatively high survival rates at 3 years which may be artificially elevated due to exclusion of adolescents, limited follow up, and deceased patient charts unavailable. Structural determinants of health in Gaza lead to limited diagnostic and treatment capabilities, limited access to advanced medical training, and reliance on out-of-territory transfers for care. These barriers impact the access to comprehensive pediatric care within the Gaza Strip.
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Affiliation(s)
- David Mills
- Boston Children's Hospital
- Harvard Medical School, Boston, MA
| | - Salah Abushanab
- Dr. Musa and Suhaila Nasir Pediatric Cancer Department, Pediatric Specialized Hospital, Gaza City
| | - Awad Elhaloul
- Dr. Musa and Suhaila Nasir Pediatric Cancer Department, Pediatric Specialized Hospital, Gaza City
| | - Heiam El Nuweiry
- Dr. Musa and Suhaila Nasir Pediatric Cancer Department, Pediatric Specialized Hospital, Gaza City
| | - Mahmoud Shbair
- Dr. Musa and Suhaila Nasir Pediatric Cancer Department, Pediatric Specialized Hospital, Gaza City
| | - Ibrahim Qaddoumi
- Global Pediatric Medicine Department, St. Jude Children's Research Hospital, Memphis, TN
| | - Zeena Salman
- Huda Al Masri Pediatric Cancer Department, Beit Jala Hospital, Beit Jala, Palestine
- Palestine Children's Relief Fund, Kent, OH
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11
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Nguyen MC, Nguyen V, Le H, Nguyen DV, Nguyen ML, Hermiston ML, Bui CB, Loh AHP. Subcutaneous panniculitis-like T-cell lymphomas with homozygous inheritance of HAVCR2 mutations in Vietnamese pedigrees. Pediatr Blood Cancer 2021; 68:e29292. [PMID: 34398505 DOI: 10.1002/pbc.29292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 07/06/2021] [Accepted: 08/02/2021] [Indexed: 11/08/2022]
Affiliation(s)
| | - Vy Nguyen
- DNA Medical Technology, Ho Chi Minh City, Vietnam
| | - Hoa Le
- Children Hospital 2, Ho Chi Minh City, Vietnam
| | | | - Mai-Lan Nguyen
- University of Medicine and Pharmacy, Ho Chi Minh City, Vietnam
| | - Michelle L Hermiston
- Department of Pediatrics, University of California San Francisco, San Francisco, California, USA.,Southeast Asia Pediatric Hematology Oncology (SEAPHO), University of California San Francisco, San Francisco, California, USA
| | - Chi-Bao Bui
- City Children's Hospital, Ho Chi Minh City, Vietnam.,School of Medicine, Vietnam National University, Ho Chi Minh City, Vietnam
| | - Amos Hong Pheng Loh
- VIVA KKH Paediatric Brain and Solid Tumour Programme, KK Womens' and Children's Hospital, Singapore.,SingHealth Duke NUS Global Health Institute, Duke NUS Medical School, Singapore
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12
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Khan MS, Al-Jadiry MF, Tarek N, Zamzam M, Saab R, Trehan A, Rihani R, AlRawas A, Jeha S, Belgaumi AF. Pediatric oncology infrastructure and workforce training needs: A report from the Pediatric Oncology East and Mediterranean (POEM) Group. Pediatr Blood Cancer 2021; 68:e29190. [PMID: 34197011 DOI: 10.1002/pbc.29190] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 05/31/2021] [Accepted: 06/01/2021] [Indexed: 11/08/2022]
Abstract
BACKGROUND Inadequate numbers of trained health care providers (HCPs) contribute to poor pediatric oncology (PO) outcomes, particularly in low- and lower middle-income countries (L/LMICs). An understanding of the characteristics of the workforce challenges is vital for addressing these problems. METHODS The Pediatric Oncology East and Mediterranean (POEM) Group surveyed PO centers in countries of North Africa, Middle East, Central Asia, and Indian subcontinent on infrastructure and workforce capacity, service availability, and training opportunities for HCPs. Participating centers were categorized by the World Bank income levels for their countries and correlated with services, workload and staffing characteristics, and training needs. RESULTS Fifty of 82 member centers (61%) from 21 countries responded to the survey. Two hundred ninety-nine pediatric oncologists and 1176 nurses treated 12 496 new PO patients/year, with a 1451-bed utilization. The majority (71%) of new cases occurred in L/LMICs. The availability of HCPs correlated with country income level, as did pediatric subspecialty access, while availability of support services was unrelated. Twenty-five centers in 11 countries offered PO fellowship training for physicians, whereas 13 PO nurse training centers in nine countries had the capacity to train 273 nurses annually. The survey respondents indicated that, among their existing workforce, an average of 3.5 physicians and 14 nurses per institution would benefit from additional PO training opportunities. CONCLUSIONS The participating centers exhibited intraregional heterogeneity in financial resources, infrastructure, workload, workforce, and medical services. Our findings provide insight into the disparities and regional resources available to POEM, which can be mobilized to rectify specific deficiencies.
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Affiliation(s)
- Muhammad Saghir Khan
- Department of Pediatrics, King Faisal Specialist Hospital and Research Center, Al Madinah Al Munawarrah, Saudi Arabia
| | - Mazin Faisal Al-Jadiry
- College of Medicine, University of Baghdad, Children's Welfare Teaching Hospital, Pediatric Oncology Unit, Medical City, Baghdad, Iraq
| | - Nidale Tarek
- Children's Cancer Institute, American University of Beirut Medical Center, Beirut, Lebanon
| | - Manal Zamzam
- Pediatric Oncology Department, Children's Cancer Hospital of Egypt (CCHE), Cairo, Egypt.,National Cancer Institute, Cairo University, Cairo, Egypt
| | - Raya Saab
- Children's Cancer Institute, American University of Beirut Medical Center, Beirut, Lebanon
| | - Amita Trehan
- Paediatric Haematology Oncology Unit, Advanced Paediatric Centre, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Rawad Rihani
- Pediatric Hematology/Oncology/Bone Marrow and Stem Cell Transplantation Department, King Hussein Cancer Center, Queen Rania Al Abdulla Street, Amman, Jordan
| | - Abduhakim AlRawas
- Child Health Department, Sultan Qaboos University Hospital, Muscat, Oman
| | - Sima Jeha
- Departments of Oncology and Global Pediatric Medicine, St Jude Children's Research Hospital, Memphis, Tennessee, USA
| | - Asim F Belgaumi
- Department of Oncology, Aga Khan University, Karachi, Pakistan
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13
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Stanway S, Lodge M, Sullivan R, Diprose K, Young AM, Crisp N, Lewis P, Eden T, Aggarwal A, Nadin A, Chinegwundoh F, Sirohi B, Byrne G, Cowan R. The UK's contribution to cancer control in low-income and middle-income countries. Lancet Oncol 2021; 22:e410-e418. [PMID: 34478677 DOI: 10.1016/s1470-2045(21)00380-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Revised: 06/04/2021] [Accepted: 06/17/2021] [Indexed: 11/24/2022]
Abstract
Cancer mortality rates in low-income and middle-income countries (LMICs) are unacceptably high, requiring both collaborative global effort and in-country solutions. Experience has shown that working together in policy, clinical practice, education, training, and research leads to bidirectional benefit for LMICs and high-income countries. For over 60 years, the UK National Health Service has benefited from recruitment from LMICs, providing the UK with a rich diaspora of trained health-care professionals with links to LMICs. A grassroots drive to engage with partners in LMICs within the UK has grown from the National Health Service, UK academia, and other organisations. This drive has generated a model that rests on two structures: London Global Cancer Week and the UK Global Cancer Network, providing a high-value foundation for international discussion and collaboration. Starting with a historical perspective, this Series paper describes the UK landscape and offers a potential plan for the future UK's contribution to global cancer control. We also discuss the opportunities and challenges facing UK partnerships with LMICs in cancer control. The UK should harness the skills, insights, and political will from all partners to make real progress.
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Affiliation(s)
| | - Mark Lodge
- UK Global Cancer Network, Manchester, UK; International Network for Cancer Treatment and Research, Oxford, UK
| | | | | | - Annie M Young
- UK Global Cancer Network, Manchester, UK; Warwick Medical School, University of Warwick, Coventry, UK
| | - Nigel Crisp
- House of Lords, Houses of Parliament, London, UK
| | - Philippa Lewis
- Department of Clinical Oncology, University Hospitals Bristol NHS Foundation Trust, Bristol, UK
| | - Tim Eden
- World Child Cancer, London, UK; School of Medical Sciences, University of Manchester, Manchester, UK
| | - Ajay Aggarwal
- Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, UK
| | | | | | | | - Ged Byrne
- Health Education England Global Engagement, London, UK; Department of Surgery, Manchester NHS Foundation Trust, Manchester, UK
| | - Richard Cowan
- UK Global Cancer Network, Manchester, UK; School of Medical Sciences, University of Manchester, Manchester, UK; Department of Clinical Oncology, The Christie NHS Foundation Trust, Manchester, UK
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14
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Van Heerden J, Kruger M. The need for resource-linked translational oncology in the management of neuroblastoma and other childhood malignancies in low- and middle-income countries. Pediatr Blood Cancer 2021; 68:e29133. [PMID: 34031971 DOI: 10.1002/pbc.29133] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2021] [Revised: 05/07/2021] [Accepted: 05/08/2021] [Indexed: 01/12/2023]
Affiliation(s)
- Jaques Van Heerden
- Paediatric Haematology and Oncology, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg Hospital, Cape Town, South Africa.,Paediatric Haematology and Oncology, Department of Paediatrics, Antwerp University Hospital, Antwerp, Belgium
| | - Mariana Kruger
- Paediatric Haematology and Oncology, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg Hospital, Cape Town, South Africa
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