Browsing by Author "Hesseling, Peter B."
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- ItemBurkitt lymphoma : trends in children below 15 years reveal priority areas for early diagnosis activities in north-west Cameroon(AOSIS, 2019) Afungchwi, Glenn M.; Hesseling, Peter B.; Achu, Paul; Bardin, Richard; Kouya, FrancineBackground: Burkitt lymphoma is one of the most common childhood cancers in Cameroon. Incidence rates of 5.9/100 000 and 2.58 per 100 000 have been reported in two studies in 2005 and 2012 amongst children below 15 years in the North-West Region. Aim: This study seeks to examine how Burkitt lymphoma incidence has varied between the various health districts of north-west Cameroon from 2003 to 2015. Setting: North-West region of Cameroon. Method: Ethics approval was obtained from the relevant university and Health Services Institutional Review Board. Population data was obtained from the regional delegation of public health. The Paediatric Oncology Networked Database registry from two hospitals and two pathology-based registries were reviewed for cases per year from the various districts. Age-standardised incidence rates were computed for all districts by year using the World Health Organizaion world standard populations. Results: A total of 317 cases were registered. Overall age-standardised incidence rate was 3.07 per 100 000. Annual incidence ranged from 0.09 in 2003 to 6.12 in 2010. The districts with the highest incidence rates for the entire study period include Nwa with 10.54; Ndop with 5.63; Benakuma with 5.48; Ako with 4.97; and Nkambe with 4.73. Conclusion: Clustering of Burkitt lymphoma is seen in the region, with the highest incidence in Nwa, Ndop, Benakuma, Ako and Nkambe. These districts should be prioritised for awareness creation campaigns. There is need for a population-based childhood cancer registry in the region, which will use both active and passive surveillance methods to record all childhood cancer cases.
- ItemBurkitt lymphoma – nutritional support during induction treatment : effect on anthropometric parameters and morbidity of treatment(AOSIS, 2018-10-22) Hesseling, Peter B.; Tamannai, Mona; Ladas, Elena; Afungchwi, Glenn; Katayi, Edouard; Kouya, FrancineBackground: Malnutrition is common in children diagnosed with cancer in Africa, and it adds to the morbidity and mortality of treatment. Nutritional support is known to reduce morbidity and mortality of treatment. Aim: The aim of this study was to record changes in anthropometric parameters, morbidity and mortality in patients admitted with Burkitt lymphoma (BL) whose diet was supplemented with protein, vitamins and minerals during induction chemotherapy. Methods: Seventy consecutive newly diagnosed BL patients were enrolled. The diet was supplemented with a daily egg, 200 mL F-75 formula and vitamins. Guardians received 3 cups of dry rice and $1 daily to buy and prepare meals for the patient and themselves whilst in the hospital. Height, weight, triceps skinfold (TSF) and mid-upper arm circumference (MUAC) were recorded on days 1 and 28. Co-morbidities at diagnosis were treated, and neutropenia and febrile episodes managed with a standard protocol. Two patients who died within 24 h after admission were excluded from the anthropometric analyses. Results: The mean age was 8 (range 2–16) years and the male:female ratio was 42:28. The St Jude stage distribution was as follows: Stage I = 6%, II = 4%, III = 69%, IV = 21%. Weight for age was < 10th centile at diagnosis in 18% (but influenced by tumour mass). Weight was unchanged or increased by ≥ 5% in 66% of patients on Day 28. The TSF was < 3rd centile in 47% of patients and increased by ≥ 0.5 cm in 57%. The MUAC was < 3rd centile in 16% of patients at diagnosis and in 10% of patients on Day 28. Febrile episodes in 60% and neutropenia in 18% of patients were successfully treated. Two patients died from presumed renal failure. The overall death rate (including the two deaths within 24 h after admission before chemotherapy was started) was 5.5% (n = 4). Conclusion: The TSF improved in the majority and the MUAC improved in some patients. Febrile neutropenia and febrile episodes could be successfully managed. The death rate during induction was lower than in our previously published results with the same chemotherapy protocol. Dietary supplementation should be a standard component of treatment in paediatric patients with cancer.
- ItemThe outcome and cost of a capacity-building training programme on the early recognition and referral of childhood cancer for healthcare workers in North-West Cameroon(John Wiley & Sons Ltd, 2020) Afungchwi, Glenn Mbah; Hesseling, Peter B.; Kouya, Francine; Enow, Sam A.; Kruger, MarianaAim: Early cancer diagnosis is necessary to improve survival rates. The aim of this study was to assess the outcome and cost of the childhood cancer training programme amongst healthcare workers. Design: This was a prospective pre–post study design, using questionnaires for preand post-training testing. The warning signs of childhood cancer were used as the main teaching content to improve recognition and early diagnosis. Methods: Pre-training and post-training knowledge, as well as attitude questionnaires, was administered at the beginning and at the end of each training workshop. Paired samples t test and chi-square were used to compare the change in knowledge and differences between groups. Results: The overall percentage knowledge score increased from 51%–85% (p < .001). The doctors had a better knowledge score than the nurses in the pre-test (70% versus 50%, p = .008), but there was no significant difference in the post-test scores. The cost of training was €25.06 per healthcare worker. Conclusion: We recommend similar training programmes in public health to improve early diagnosis of childhood cancer.
- ItemThe role of traditional healers in the diagnosis and management of Burkitt lymphoma in Cameroon : understanding the challenges and moving forward(BioMed Central, 2017-04-11) Afungchwi, Glenn M.; Hesseling, Peter B.; Ladas, Elena J.Background Burkittlymphoma(BL) is the most common childhood cancer in Cameroon with a reported incidence of 3 per 100,000 children under 15 years in the Northwest region. Treatment at three Baptist mission hospitals has a recorded cure rate of over 50%. Traditional medicine(TM) is recognized by the national health system, but its scope is undefined and entraps children with BL. The aim of this study was to investigate the attitudes and practices of parents and traditional healers (TH) towards TM in children with BL in order to develop recommendations for an integrative approach and improved access to life-saving treatment for children with BL. Methods This is a descriptive case series of children diagnosed with BL treated at Banso, Mbingo, and Mutengene Baptist Hospitals between 2003 and 2014. A questionnaire was used to obtain the following information: demographic information, religion, the rate of use of TM, reasons why guardians chose to use TM, the diagnoses made by the TH, treatment offered, and the type of payment requested, based on the accounts of patient caregivers. Data was analyzed using Center for Disease Control Epi Info 7. Results Three hundred eighty-seven questionnaires were completed by parents/guardians. 55% had consulted a TH, of whom 76.1% consulted the TH as first choice. Common diagnoses provided by TH included liver problem, abscess, witchcraft, poison, hernia, side pain, mushroom in the belly and toothache. Methods of management included massage, cuts, concoctions, and incantations. The fee for these services included chickens, farm tools, and cash ranging from 200FCFA (0.4USD) to 100,000FCFA(200USD). The choice of TM was based on accessibility, failed clinic/hospital attendance, recommendation of relatives, and belief in TM. Conclusions TH are involved in BL management in Cameroon. TH are ignorant about BL, resulting in non-referral, and thus delay in diagnosis and treatment. Collaboration with TH could reduce late diagnosis and improve cure rates of BL and other childhood cancers.
- ItemWorking together to build a better future for children with cancer in Africa(American Society of Clinical Oncology, 2020) Chitsike, Inam; Paintsil, Vivian; Sung, Lillian; Njuguna, Festus; Mavinkurve-Groothuis, Annelies; Kouya, Francine; Hesseling, Peter B.; Kaspers, Gertjan; Afungchwi, Glenn M.; Ilbawi, Andre; Renner, Lorna; Pritchard-Jones, Kathy; Hessissen, Laila; Molyneux, Elizabeth; Chagaluka, George; Israels, TrijnENGLISH ABSTRACT: No abstract available