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Anieto EM, Madzimbe P, Potterton J, Delano P, Makupe P, Geel J, Ranasinghe N, Challinor J, Sidhanee A. Paediatric oncology physiotherapy in Africa: International Society of Paediatric Oncology (SIOP) Global Mapping Programme. Pediatr Blood Cancer 2024; 71:e31299. [PMID: 39189659 DOI: 10.1002/pbc.31299] [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: 12/24/2023] [Revised: 07/02/2024] [Accepted: 08/18/2024] [Indexed: 08/28/2024]
Abstract
Childhood cancer treatment in Africa has a dramatically increasing patient population resulting in greater rehabilitation needs. The International Society of Paediatric Oncology (SIOP) mapped childhood cancer services in Africa including access to physiotherapy. Irrespective of income classification, just over two-thirds of countries in Africa reported having access to physiotherapy services in paediatric oncology sites. There is a lack of knowledge about African childhood physiotherapy services. Research is needed to understand the rehabilitation needs of these children/adolescents and how to meet their needs in a globally equitable and sustainable way.
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Affiliation(s)
- Ebuka Miracle Anieto
- School of Allied Health Sciences, University of Suffolk, Ipswich, UK
- Department of Physiotherapy and Paramedicine, Glasgow Caledonian University, Scotland, UK
| | - Precious Madzimbe
- Department of Physiotherapy, School of Therapeutic Sciences, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Joanne Potterton
- Department of Physiotherapy, School of Therapeutic Sciences, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Pia Delano
- Center for Research in Occupational Health (CISAL), Universitat Pompeu Fabra, Barcelona, Spain
| | - Prince Makupe
- Physiotherapy Department, Kamuzu Central Hospital, Lilongwe, Malawi
| | - Jennifer Geel
- Division of Paediatric Haematology and Oncology, Department of Paediatrics and Child Health, Faculty of Health Sciences, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa
| | - Neil Ranasinghe
- Lead Technical Author, Capital Markets, London Stock Exchange Group, London, UK
| | - Julia Challinor
- School of Nursing, University of California San Francisco, San Francisco, California, USA
| | - Abu Sidhanee
- Division of Physiotherapy, Institute of Health and Social Care, London South Bank University, London, UK
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Howard SC, Avagyan A, Workeneh B, Pui CH. Tumour lysis syndrome. Nat Rev Dis Primers 2024; 10:58. [PMID: 39174582 DOI: 10.1038/s41572-024-00542-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/18/2024] [Indexed: 08/24/2024]
Abstract
Tumour lysis syndrome (TLS) represents a critical oncological emergency characterized by extensive tumour cell breakdown, leading to the swift release of intracellular contents into the systemic circulation, outpacing homeostatic mechanisms. This process results in hyperuricaemia (a by-product of intracellular DNA release), hyperkalaemia, hyperphosphataemia, hypocalcaemia and the accumulation of xanthine. These electrolyte and metabolic imbalances pose a significant risk of acute kidney injury, cardiac arrhythmias, seizures, multiorgan failure and, rarely, death. While TLS can occur spontaneously, it usually arises shortly after the initiation of effective treatment, particularly in patients with a large cancer cell mass (defined as ≥500 g or ≥300 g/m2 of body surface area in children). To prevent TLS, close monitoring and hydration to improve renal perfusion and urine output and to minimize uric acid or calcium phosphate precipitation in renal tubules are essential. Intervention is based on the risk of a patient of having TLS and can include rasburicase and allopurinol. Xanthine, typically enzymatically converted to uric acid, can accumulate when xanthine oxidases, such as allopurinol, are administered during TLS management. Whether measurement of xanthine is clinically useful to optimize the use of allopurinol or rasburicase remains to be determined.
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Affiliation(s)
- Scott C Howard
- Resonance, Memphis, TN, USA.
- Yeolyan Center for Hematology and Oncology, Yerevan, Armenia.
- Sant Joan de Déu Hospital Barcelona, Barcelona, Spain.
| | - Anna Avagyan
- Yeolyan Center for Hematology and Oncology, Yerevan, Armenia
| | - Biruh Workeneh
- University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Ching-Hon Pui
- Department of Oncology, St. Jude Children's Research Hospital, Memphis, TN, USA.
- Department of Pathology, St. Jude Children's Research Hospital, Memphis, TN, USA.
- Department of Global Paediatric Medicine, St. Jude Children's Research Hospital, Memphis, TN, USA.
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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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Chantada L, Gorostegui M, Lowe J, Ranasinghe N, Villegas L, Geel J, Howard S, Bouffet E, Chantada G, Challinor J, Cappellano A. SIOP pediatric oncology services Global Mapping Program: Latin American data collection. Pediatr Blood Cancer 2024; 71:e30796. [PMID: 38054692 DOI: 10.1002/pbc.30796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Accepted: 11/18/2023] [Indexed: 12/07/2023]
Abstract
The International Society of Paediatric Oncology (SIOP) launched a program to map all pediatric cancer facilities around the world. After the results in Africa were completed, the strategy for data collection for Latin America was revised to improve the accuracy and avoid duplications. In partnership with SIOP, the Sociedad Latino Americana de Oncología Pediátrica (SLAOP) approached their delegates who provided the contacts for a 10-question survey about their institutional capacities. Data were collected by email, online meetings, or telephone calls, and stored in a secure platform. All but one country participated and a high number of centers were recorded.
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Affiliation(s)
- Luisa Chantada
- Service of Pediatric Surgery, Hospital Italiano, Buenos Aires, Argentina
| | - Maite Gorostegui
- Pediatric Cancer Center Barcelona (PCCB), Hospital Sant Joan de Déu, Barcelona, Spain
| | | | | | | | - Jennifer Geel
- Faculty of Health Sciences, School of Clinical Medicine, University of the Witwatersrand, Charlotte Maxeke Johannesburg Academic Hospital, Toronto, Ontario, Canada
| | - Scott Howard
- Pediatric Cancer Center Barcelona (PCCB), Hospital Sant Joan de Déu, Barcelona, Spain
- Resonance, Memphis, Tennessee, USA
| | - Eric Bouffet
- Hospital for Sick Children, Toronto, Ontario, Canada
| | - Guillermo Chantada
- Pediatric Cancer Center Barcelona (PCCB), Hospital Sant Joan de Déu, Barcelona, Spain
- Fundación Perez-Scremini, Montevideo, Uruguay
| | - Julia Challinor
- University of California San Francisco, San Francisco, California, USA
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Phiri L, Li WHC, Phiri PGMC, Cheung AT, Wanda‐Kalizang'oma W, Kamwendo A, Lemon S. Experiences of caregivers of children with cancer in Malawi: A qualitative study. Cancer Med 2024; 13:e6963. [PMID: 38379330 PMCID: PMC10844995 DOI: 10.1002/cam4.6963] [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: 11/07/2023] [Revised: 01/05/2024] [Accepted: 01/12/2024] [Indexed: 02/22/2024] Open
Abstract
BACKGROUND Studies have shown that caregivers of children with cancer experience challenges when caring for their children. To date, no studies have examined the experience of caregivers of children with cancer in Malawi, a low-income country in sub-Saharan Africa. Hence, this study aimed to explore the experiences of caregivers of Malawian children receiving cancer treatment. METHODS This explorative qualitative study used semi-structured interviews to collect data from 22 caregivers of children receiving cancer treatment. The data were analysed using qualitative content analysis. RESULTS Five themes emerged from the QCA. The caregivers perceived their children's cancer as a burden, a form of psychological torture and a disruptor of family routines and social lifestyles. They also reported self-isolation due to the stigma that they faced in the course of caring for their children and a need for informational, psychosocial, spiritual and financial support. CONCLUSION Caregivers of Malawian children with cancer experience physical and psychosocial challenges as they are caring for their children with cancer. Developing appropriate interventions would enable nurses to offer optimal support to these caregivers in dealing with these challenges and meeting their needs effectively.
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Affiliation(s)
- Lophina Phiri
- The Nethersole School of Nursing, Faculty of MedicineThe Chinese University of Hong KongShatinNew TerritoriesHong Kong
| | - William Ho Cheung Li
- The Nethersole School of Nursing, Faculty of MedicineThe Chinese University of Hong KongShatinNew TerritoriesHong Kong
| | - Patrick G. M. C. Phiri
- Institute of Applied Technology, Fatima College of Health SciencesAl AinAbu DhabiUnited Arab Emirates
| | - Ankie Tan Cheung
- The Nethersole School of Nursing, Faculty of MedicineThe Chinese University of Hong KongShatinNew TerritoriesHong Kong
| | | | | | - Sellina Lemon
- Baylor College of Medicine Childrens Foundation, Global HOPE ProjectLilongweMalawi
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van Heerden J, Balagadde-Kambugu J, Angom R, Lusobya RC, Chantada G, Desjardins L, Fabian ID, Israels T, Paintsil V, Hessissen L, Diouf MN, Elayadi M, Turner SD, Kouya F, Geel JA. Evaluating the baseline survival outcomes of the "six Global Initiative for Childhood Cancer index cancers" in Africa. Pediatr Hematol Oncol 2022; 40:203-223. [PMID: 36369884 DOI: 10.1080/08880018.2022.2140860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Limited survival data for the six Global Initiative for Childhood Cancer (GICC) priority cancers are available in Africa. Management of pediatric malignancies in Africa is challenging due to lack of resources, setting-specific comorbidities, high rates of late presentation and treatment abandonment. Reporting of outcome data is problematic due to the lack of registries. With the aim of evaluating the feasibility of baseline outcomes for the six index cancers, we present a descriptive analysis of respective survival rates in Africa. The survival rates were between 18% (lower middle-income countries) to 82.3% (upper middle-income countries) for acute lymphoblastic leukemia, between 26.9% (low-income countries) to 77.9% (upper middle-income countries) for nephroblastoma, between 23% (low-income countries) to 100% (upper middle-income countries), for retinoblastoma, 45% (low-income countries) to 95% (upper middle-income countries) for Hodgkin lymphoma and 28% (low-income countries) to 76% (upper middle-income countries) for Burkitt lymphoma. Solutions to improve survival rates and reported outcomes include establishing and funding sustainable registries, training and to actively include all countries in consortia from different African regions.HighlightsContinental differences in childhood cancer management such lack of resources, setting-specific comorbidities, high rates of late presentation and treatment abandonment, present challenges to the achievement of Global Initiative for Childhood Cancer goals.The available data registries do not adequately inform on the true incidences and outcomes of childhood cancers in Africa.The pathophysiology of some childhood cancers in Africa are associated with high-risk prognostic factors.Outcomes can be improved by greater regional collaboration to manage childhood cancer based on local resources and tumor characteristics.Some individual countries have reached the Global Initiative for Childhood Cancer goals for single cancers and it should be possible for more African countries to follow suit.
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Affiliation(s)
- Jaques van Heerden
- Pediatric Hematology and Oncology, Department of Pediatrics, Antwerp University Hospital, Antwerp, Belgium.,Pediatric hematology and Oncology, Department of Pediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg Hospital, Cape Town, South Africa.,Department of Pediatric Oncology, Uganda Cancer Institute, Kampala, Uganda
| | | | - Racheal Angom
- Department of Pediatric Oncology, Uganda Cancer Institute, Kampala, Uganda
| | - Rebecca Claire Lusobya
- Department of Ophthalmology, School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Guillermo Chantada
- Department of Pediatric Oncology, Hospital Sant Joan de Deu, Barcelona, Spain
| | | | - Ido Didi Fabian
- Goldschleger Eye Institute, Sheba Medical Center, Tel Hashomer, Tel-Aviv University, Tel-Aviv, Israel.,International Center for Eye Health London School of Hygiene and Tropical Medicine, London, UK
| | - Trijn Israels
- Department of Pediatrics, Queen Elizabeth Central Hospital, Kamuzu University of Health Sciences, Blantyre, Malawi
| | - Vivian Paintsil
- Department of Child Health, School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Laila Hessissen
- Pediatric Hematology and Oncology Center, University Mohammed V Rabat, Rabat, Morocco
| | | | - Moatasem Elayadi
- Department of Pediatric Oncology, National Cancer Institute, Egypt & Children Cancer Hospital of Egypt (CCHE-57357), Cairo University, Giza, Egypt
| | | | - Francine Kouya
- Department of Pediatric Oncology, Cameroon Baptist Convention Hospitals in Mutengene, Mbingo and Banso, Mutengene, Cameroon
| | - Jennifer A Geel
- Division of Pediatric Hematology-Oncology, Charlotte Maxeke Johannesburg Academic Hospital, University of the Witwatersrand, Witwatersrand, South Africa
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