Vincristine (VCR) is a critical part of treatment in pediatric malignancies and associated with dose-dependent peripheral neuropathy (vincristine-induced [VIPN]). Our previous findings show VCR metabolism regulated by the CYP3A5 gene. Individuals who are low expressers metabolize slower experience more severe VIPN as compared to high expressers. Preliminary observations suggest that Caucasians nonCaucasians.Kenyan children cancer were undergoing including recruited for prospective cohort...

Background Kenyan national policies for public hospitals dictate that patients are retained on hospital wards until their bills paid, but this payment process differs with or without access to National Hospital Insurance Fund (NHIF) at diagnosis. Whether these differences impact treatment outcomes has not been described. Our study explores whether childhood cancer in Kenya influenced by health‐insurance status and retention policies. Procedure This combined retrospective review of medical...

Wilms tumor is the commonest renal malignancy in childhood. Survival high-income countries approximately 90%, whereas low-income countries, it less than 50%. This study assessed treatment outcomes of patients with at a Kenyan academic hospital.We conducted retrospective medical record review all children diagnosed between 2010 and 2012. Data on various sociodemographic clinical characteristics were collected.Of 39 tumor, 41% had event-free survival, 31% abandoned treatment, 23% died, 5%...

<h3>Objective</h3> Non-Hodgkin's lymphoma (NHL) is the most common childhood malignancy in sub-Saharan Africa. Survival rates for NHL are higher than 80% high-income countries. This study explores treatment outcomes of children with Kenya, a low-income country, and association between health insurance status at diagnosis outcomes. <h3>Design</h3> was retrospective medical records study. All diagnosed 2010, 2011 2012 were included. Data on collected. <h3>Results</h3> Of all 63 patients NHL,...

Wilms tumor (WT) is a curable type of cancer with 5-year survival rates over 90% in high-income countries, whereas this less than 50% low- and middle-income countries. We assessed treatment outcomes children WT treated at large Kenyan teaching referral hospital.We conducted retrospective record review diagnosed between 2013 2016. Treatment protocol consisted 6 weeks preoperative chemotherapy surgery, 4-18 postoperative depending on disease stage. Probability event-free (pEFS) overall (pOS)...

Abstract Introduction Western Kenya is home to approximately 24 million people, with 10 children under the age of 15 years. 1 Based on estimates cancer incidence in similar populations from around world, 1500 patients should be diagnosed pediatric each year. This article describes international collaboration that investigates potential barriers preventing effective diagnosis cancer. Methods Here, we describe a multidisciplinary and sequential approach better evaluate complex factors...

Few governments in low and middle-income countries (LMIC) have responded favourably to the international plea for Universal Health Coverage. Childhood cancer survival LMIC is often below 20%. Limited health-insurance coverage may contribute this poor survival. Our study explores influence of status on childhood treatment outcomes a Kenyan academic hospital.This was retrospective medical records review all children diagnosed with at Moi Teaching Referral Hospital between 2010 2016....

Abstract Purpose Traditional and complementary alternative medicine (TCAM) use is rising globally. In many African countries, TCAM has been a way of life as the first last resort remedy for ailments, including cancer. Health‐care providers (HCP) should address this need properly. This study explores HCP perspectives on in Kenya. Methods cross‐sectional used questionnaires. involved care children with cancer at Kenyan academic hospital were interviewed. Results total, 155 (response rate 79%)...

The low incidence of vincristine-induced peripheral neuropathy (VIPN) in Kenyan children may result from vincristine exposure. We performed a pharmacokinetically (PK) guided dose-escalation feasibility study (NCT05844670). Vincristine PK exposure was assessed with previously developed nomogram. A 20% dose increase recommended for participants and no VIPN, hyperbilirubinemia or malnutrition. None the fifteen VIPN. Low seen only one participant: implemented without side-effects. Average high....

Abstract The low incidence of vincristine‐induced peripheral neuropathy (VIPN) in Kenyan children may result from vincristine exposure. We studied exposure and dose‐escalated case (NCT05844670). Average was high. Individual assessed with a previously developed nomogram. A 20% dose increase recommended for participants no VIPN, hyperbilirubinemia, or malnutrition. None the 15 VIPN. Low seen one participant: implemented without side effects. In conclusion, did not develop VIPN despite having high

Pediatric acute myeloid leukemia (AML) is a challenging disease to treat in low- and middle-income countries (LMICs). Literature suggests that survival LMICs poorer compared with high-income (HICs).This study evaluates the outcomes of Kenyan children AML impact sociodemographic clinical characteristics on outcome.A retrospective medical records was performed at Moi Teaching Referral Hospital (MTRH) Eldoret, Kenya, between January 2010 December 2018. Sociodemographic characteristics,...

The Pediatric Oncology in Developing Countries (PODC) committee of the International Society (SIOP) published a pediatric acute myeloid leukemia (AML)-specific adapted treatment guideline for low- and middle-income countries. We evaluated outcomes children with AML at large Kenyan academic hospital before (period 1) after 2) implementing this guideline.Records (≤17 years) newly diagnosed between 2010 2021 were retrospectively studied. In period 1, induction therapy comprised two courses...

Physician dual practices (PDP) can be defined as 'doctors combining clinical work in public and private health-sector.' This study explores the impact of PDP on a long-term pediatric-oncology outreach-program between large referral hospitals Netherlands, Indonesia Kenya.This cross-sectional descriptive used self-administered semi-structured survey. The most senior doctor from each partner site was interviewed June 2022. survey contained 70 closed-ended 7 open-ended questions took 30-45...

Early deaths and treatment nonadherence are major reasons for low childhood acute lymphoblastic leukemia (ALL) survival in low- middle-income countries. This study assessed outcomes of children presenting with ALL evaluated perspectives health-care providers (HCP) on at a Kenyan academic hospital.This was combined retrospective medical records cross-sectional questionnaire study. Treatment 136 diagnosed between 2010 2016 were collected. Questionnaires completed by 245 HCP (response rate,...

11000 Background: Childhood cancer has an annual incidence of 150-160 cases per million children worldwide but remains vastly under-diagnosed in low to middle income countries (LMIC) such as Sub-Saharan Africa. Moi Teaching and Referral Hospital (MTRH) is the only tertiary referral hospital western Kenya serves a population 25 people, including 10 children. The average number pediatric diagnoses was 216 annually 2017-2019, well below anticipated 1500 based on epidemiology data. We recently...

Acute lymphoblastic leukemia/lymphoma is a highly aggressive neoplasm of precursor lymphoid (blast) cells. There are 2 main subtypes based on lineage; B (B-ALL/LBL) and T (T-ALL/LBL). B-ALL/LBL commonly presents with fever, fatigue, bone or joint pain, bleeding anorexia (signs marrow infiltration), lymphadenopathy, hepatosplenomegaly, involvement skin, soft tissue testes, predilection for the central nervous system. Immature cell markers, such as CD34 TdT, can help to differentiate...

Background: In our earlier published outcomes of children with acute lymphoblastic leukemia (ALL) at Moi Teaching and Referral Hospital in Kenya (MTRH), we showed low event-free survival (EFS) high induction mortality abandonment. Based on this observation, the team focused strategies to reduce both causes poor outcomes. Intervention: We dropped doxorubicin from therapy as supply L-asparaginase became reliable, improved social financial support for insurance coverage transportation, promptly...

Febrile neutropenia is an oncological emergency in children with cancer, associated serious infections and complications. In low-resourced settings, death from cancer 20 times higher than high-resourced treatment thought to be related delays antibiotic administration management. The barriers effective management of fever episodes have not previously been described. This convergent mixed-methods study will provide the evidence develop guidelines inform their implementation at Moi Teaching...

2601 Background: In a U.S. population, cytochrome P450 (CYP) 3A5 high-expressers metabolize vincristine (VCR) more efficiently than low-expressers and vincristine-induced peripheral neuropathy (VIPN) is less common in African-Americans Caucasians. We test the hypothesis that children Kenya are CYP3A5 compared to as such experience VIPN. Methods: This study was conducted Kenyan with cancer (n=78) being treated VCR at Moi University AMPATH Oncology Institute partnership Indiana University....