Medics said financial support for families must be strengthened. They said expanding public health insurance to cover all pediatric cancer treatments would prevent parents from abandoning care due to cost concerns.
Only 13 per cent of these children remained free of severe complications two years after diagnosis.
A new study
has revealed a gloomy reality for children diagnosed with brain tumours in
Western Kenya.
Only three
out of every 10 children survive beyond two years without complications after diagnosis,
according to a study of the largest cohort of Kenyan paediatric brain tumour
patients to date.
Although event-free
survival rate varies greatly depending on the type and grade of the tumour, it
generally falls within a range of 25 per cent to 70 per cent at five years in
many countries.
The
situation is drastically different for Kenyan children. The study, conducted at
Moi Teaching and Referral Hospital (MTRH) in Eldoret, examined 79 paediatric
brain tumour cases between 2015 and 2022.
It found
that only 13 per cent of these children remained free of severe complications
two years after diagnosis.
Event-free
survival time referred to the time between the suspected diagnosis and the
first event of treatment failure (treatment abandonment, death, progressive or
relapsed disease) or the last known date that the patient was alive.
“The survival
rate is alarmingly low,” the researchers noted. “Most of these children either
die, experience tumour progression, or abandon treatment due to financial and
logistical challenges.”
Their paper
–Pediatric Brain Tumors in Western Kenya: Patient Outcomes and Healthcare
Providers’ Perspectives – was published last month in the journal Pediatric
Blood & Cancer.
Brain tumours
are among the most dangerous cancers in children. In high-income countries,
early detection, advanced medical treatments, and coordinated healthcare
systems have significantly improved survival rates.
The study
identified several key reasons why Kenyan children with brain tumours fare so
poorly compared to their counterparts in wealthier nations.
Late
diagnosis is a major issue. Researchers noted that many children arrive at the
hospital when their tumours are already advanced, making treatment more
difficult.
Symptoms
like persistent headaches, vomiting, and difficulty walking are often mistaken
for common illnesses like malaria or meningitis. “By the time they reach a
specialist, the tumour has often grown too large for effective treatment,” the
study states.
Treatment
abandonment is also a serious problem. Nearly half of the children in the study
stopped treatment prematurely. This is often due to the high cost of care, long
travel distances to the hospital, and a lack of understanding about the
disease. “The lack of keeping track of patients was repeatedly mentioned to
result in abandonment and failure to complete all the intended treatment
modalities,” the report says.
One neurosurgeon involved in the study
explained, “Some parents believe surgery alone is enough. They don’t realize
that chemotherapy and radiotherapy are also essential for long-term survival.”
Limited
access to essential treatments further worsened the outcomes. While surgery is
the primary treatment, follow-up therapies like chemotherapy and radiotherapy were
often inaccessible.
Until 2021,
MTRH did not even have a radiotherapy machine, meaning that children had to
travel long distances for radiation treatment. Many families simply could not
afford this.
Additionally,
shortages of trained specialists and equipment made it difficult to provide
timely and high-quality care. The hospital lacks enough neurosurgeons,
oncologists, and specialized nurses. Pathology services, which are crucial for
diagnosing tumour types, are also inadequate. One paediatric oncologist
described the situation as “a system that is overwhelmed and under-resourced.”
The experts
offered several recommendations to improve survival rates for children with
brain tumours in Kenya.
First,
better early detection programmes should be established. Awareness campaigns
should educate parents and healthcare workers about the warning signs of brain
tumours.
Second,
financial support for families must be strengthened. They said expanding public
health insurance to cover all paediatric cancer treatments would prevent
parents from abandoning care due to cost concerns.
Third,
stronger hospital infrastructure is needed, including the need for more trained
specialists. The study urges the government and medical institutions to train
more paediatric neurosurgeons, oncologists, and support staff. Establishing a
clear national treatment guideline for paediatric brain tumors could also improve
care coordination.
The study
also explored the challenges and opportunities in multidisciplinary care for paediatric
brain tumours. One of the major barriers is the lack of coordination among
different departments. As one neurosurgery resident noted: “The first thing is
usually the lack of ICU. So our patients, many times require ICU
postoperatively... but that means for that week you will not be able to take
peads to theatre as we speak.”
Another challenge
is the delay in referrals between departments. A paediatric oncology consultant
remarked, “I think we’ve moved from them informing us after they’ve done
everything. Because before most of the time, you’ll be told about it once
they’re out of surgery, they’ve gone to ICU. Now they are informing earlier and
earlier, which is, I think, OK, good.”
According
to the American Cancer Society, most children who are diagnosed early and are
offered proper treatment can survive this cancer.
ACS says about
three out of four children with brain tumours (all types combined) survive at
least five years after being diagnosed.
But the
outlook can vary a great deal based on the type of tumour, where it is, and
other factors.
The World
Health Organisation says more than 1000 children are diagnosed with different
types of cancer every day across the world.
“Recent
medical advances make for very high chances of survival in high-income
countries, where more than 80 per cent of children diagnosed with cancer will
survive. Yet only about 20 per cent of children diagnosed with cancer will
survive in some low- and middle-income countries,” WHO says.
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Only 13 per cent of these children remained free of severe complications two years after diagnosis.