Abstract
Background: Childhood cancer affects over 300,000 children annually worldwide, with lower cure rates in resource-limited countries. Despite advancements, about 14% of children worldwide die within 5 years, partly due to therapy-related complications like cardiotoxicity. In Tanzania, echocardiography is not routinely integrated into cancer therapy services, leading to delayed diagnoses and management of therapy-related cardiac abnormalities in children.

Objectives: This study aimed at determining the prevalence, patterns, and factors associated with echocardiographic abnormalities in children receiving cancer therapy at Bugando Cancer Centre.

Methods: This cross-sectional study, conducted from December 2023 to May 2024, involved 156 children aged 1 to 18 years, using convenient sampling. Clinical assessments and 2D echocardiographic evaluations were performed on all participants. Data were analyzed with STATA version 15, describing categorical variables as proportions and continuous variables as means or medians with ranges. Univariate and multivariate logistic regression identified factors associated with cardiac abnormalities, with P value < 0.05 considered statistically significant.

Results: The study enrolled 156 children, with a majority being preschool-aged (48.1%) and with slight male predominance (55.8%). The prevalence of cardiac abnormalities was 44.9%, with valvular insufficiency, particularly tricuspid regurgitation, being the most common. Factors such as mild anemia (OR: 2.8, 95% CI: 1.0-7.8) and solid tumors (OR: 2.4, 95% CI: 1.1-4.7) were associated with higher odds of cardiac abnormalities.

Conclusion: The high prevalence of cardiac abnormalities in this study underscores the significant cardiotoxic impact of cancer therapies in pediatric patients. This finding emphasizes the need for vigilant cardiac monitoring and tailored interventions to mitigate long-term cardiovascular risks.