Initiating Childhood Cancer Treatment in Rural Rwanda: A Partnership-Based Approach

Pediatric Blood & Cancer
Sara StulacLawrence N Shulman

Abstract

More than 85% of pediatric cancer cases and 95% of deaths occur in resource-poor countries that use less than 5% of the world's health resources. In the developed world, approximately 81% of children with cancer can be cured. Models applicable in the most resource-poor settings are needed to address global inequities in pediatric cancer treatment. Between 2006 and 2011, a cohort of children received cancer therapy using a new approach in rural Rwanda. Children were managed by a team of a Rwandan generalist doctor, Rwandan nurse case manager, Rwanda-based US-trained pediatrician, and US-based pediatric oncologist. Biopsies and staging studies were obtained in-country. Pathologic diagnoses were made at US or European laboratories. Rwanda-based clinicians and the pediatric oncologist jointly generated treatment plans by telephone and email. Treatment was provided to 24 patients. Diagnoses included lymphomas (n = 10), sarcomas (n = 9), leukemias (n = 2), and other malignancies (n = 3). Standard chemotherapy regimens included CHOP, ABVD, VA, COP/COMP, and actino-VAC. Thirteen patients were in remission at the completion of data collection. Two succumbed to treatment complications and nine had progressive disease. There were no patie...Continue Reading

References

Nov 18, 2004·Pediatric Blood & Cancer·Peter HesselingElizabeth Molyneux
Jul 22, 2010·Cancer Epidemiology, Biomarkers & Prevention : a Publication of the American Association for Cancer Research, Cosponsored by the American Society of Preventive Oncology·Ahmedin JemalElizabeth M Ward
Jan 22, 2013·BMJ : British Medical Journal·Paul E FarmerPeter C Drobac
Jul 1, 2014·Academic Medicine : Journal of the Association of American Medical Colleges·Corrado CanceddaAgnes Binagwaho

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