An evaluation of the disparities affecting the underdiagnosis of pediatric cancer in Western Kenya
Tyler Severance, Festus Njuguna, Gilbert Olbara, Maureen Kugo, Sandra Langat, Saskia Mostert, Larissa Klootwijk, Jodi Skiles, Scott Coven, Kathleen Overholt, Gertjan J.L. Kaspers, Terry A. Vik
Abstract
INTRODUCTION: Based on estimates of cancer incidence in similar populations from around the world, approximately 1500 patients should be diagnosed with pediatric cancer each year. This article describes the international collaboration that investigates potential barriers preventing the effective diagnosis of pediatric patients with cancer. METHODS: Here, we describe a multidisciplinary and sequential approach to better evaluate the complex factors affecting the lack of appropriate diagnosis of pediatric cancer in Western Kenya. RESULTS: Internal review at a large tertiary hospital noted 200-250 patients were diagnosed annually, suggesting the remaining 75%-80% of patients go undiagnosed and do not receive treatment. Following our screening process at a local referring hospital, 41 malaria slides demonstrated both morphologic and genetic evidence of leukemia. Knowledge assessments of local providers at referring institutions suggested a lack of education and training as the factors that contribute to lower rates of diagnosis. DISCUSSION: Through a multi-step approach, our teams were better able to isolate potential issues impeding the appropriate and timely diagnosis of pediatric cancer in Kenya.