Addressing Challenges and Exploring Prospects in Childhood Cancer Care in Cameroon

Author(s): Andreas Frambo, Berthe Sabine Esson Mapoko, Valirie Ndip Agbor, Joseph Nkfusai, Sophie De Chazal, Nyemb Mbog Grace, Armelle Kamdem, Glenn M. Afungchwi, Francine Tchintseme, Emily Kobayashi, Ousmane Diaby, Angelle Hermine Pondy, Paul Ndom, Yauba Saidu

Background: Childhood cancers is the sixth cause of global cancer burden. Indeed, 90% of these cases occur in low- middle-income countries (LMICs), where mortality can be 4-5 folds higher compared to high income settings. In addition, many LMICs lack pediatric oncology data for policy and resource prioritization. In this paper, we describe the state of pediatric cancer care and treatment in Cameroon.

Procedure: We conducted cross-sectional survey in July 2020, enabling data collection from the two hospitals providing pediatric oncology services including treatment type, human resource, disease type, diagnostic capacity, treatment dropout, disclosure, and data management.

Result: Both surveyed hospitals offered pediatric chemotherapy and palliative care services. However, neither offered nuclear medicine nor radiotherapy services. Human resources were grossly insufficient in both hospitals with one pediatric hemato-oncologist, one medical oncologist, one resident pediatric oncologist, one pediatric surgeon, and 14 oncology nurses. About 40% (18/45) of staff had received formal oncology training. In both settings, there was limited capacity for case finding, diagnosis and counselling. Burkitt’s lymphoma, (39, 23%) was the main childhood cancer type. Nearly 30% of eligible patients for chemotherapy, did not receive their treatment. Amongst those who received, 19% dropped out, mainly due to lack of funds to continue treatment sessions. Data collection and transmission tools varied per facility with no defined schedule for data reporting.

Conclusions: Several factors negatively impact optimal pediatric cancer care and treatment in Cameroon. We identified inadequate human resource capacity, limited case finding and diagnostic capacity, significant treatment dropout rates due to high treatment costs, and lack of harmonized data systems. Taking a systematic approach to addressing these health system components, especially through the development and implementation of a pediatric cancer national strategy has the potential to enhance case finding and treatment outcomes of pediatric cancer patients in Cameroon.