Abstract:

Background: Interventions are needed in low - and middle-income countries including Tanzania to address global disparities in child survival after cancer diagnosis. Nearly a decade, Tanzania has established zonal cancer centers and introduced comprehensive cancer care services as mitigation measures.

Objective: The objective of this study was to evaluate prognostic factors associated with a two-year survival rate among children under comprehensive cancer care at Bugando Medical Centre in Northwestern Tanzania.

Methods: This is a retrospective cohort study of children with cancer, diagnosed and treated at Bugando Medical Centre between January 2017-December 2019.Apre-test checklist was used for data collection from patients’ medical records, registry, and other sources. The data were entered to excel, cleaned and analyzed using statistical package for social sciences. Categorical variables were summarized as proportions while continuous variables were summarized as mean ± standard deviation and presented in tables. Univariate and multivariate logistic regression analysis was conducted to determine predictors associated with two-year survival rate. The 95% confidence interval was determined and p value < 0.05 was considered statistically significant.

Results: A total of 369 children with mean age of 6.5 years (standard deviation=4.6) participated in this study. The majority of participants were males (54.2%), aged < 5 years (48.8%), from Mwanza region (23.6%), had no family history of cancer (95.4%), diagnosed with Lymphoma (32.0%) followed with nephroblastoma (21.9%), and leukemia (13.3%).Participants with unclassified cancer stage (59.3 %) and high cancer risk (96.2 %) were the majority. Among the participant with cancers staging results, most of them had stage 3 or 4 (26.6%). Anemia was the most common comorbidity (20.6%) as followed by malnutrition (3.3%).A child's place of residence (by region) and time spent after enrollment into comprehensive cancer care at Bugando Medical Centre were found to be independent predictors of two-year survival.

Conclusion: This study gives update of two-year survival rate among children diagnosed with cancer in Northwestern Tanzania. Therefore, provision of educational interventions relating with childhood cancer to the public by considering their residence and time spend post enrollment into comprehensive cancer care are recommended.