Neonatology and Perinatology

Biography

H A Martijn has recently completed Medical School in VU University Medical Center Amsterdam, The Netherlands. He has published a number of papers regarding
Pediatric Oncology. The papers were written based on his research period in Kenya where, Dr. S Mostert, Dr. F Njuguna and Doctor2Doctor, conducted prospective,
retrospective and medical record based research.

Abstract

Background: Non-Hodgkin lymphoma (NHL) is the most common childhood malignancy in Sub-Saharan Africa. Survival
rates for NHL are higher than 80% in high-income countries. This study explores treatment outcomes of children with NHL in
Kenya, a Sub-Saharan low-income country, and determines the influence of health-insurance status at diagnosis on treatment
outcomes.
Methods: This was a retrospective medical records study. All children diagnosed with NHL from 2010 until 2012 were included.
Data on treatment outcomes and health-insurance status at diagnosis were collected.
Results: Of all 63 NHL patients, 35% abandoned treatment, 22% had progressive or relapsed disease, 14% died, and 29%
had event-free survival. Most patients (73%) had no health-insurance at diagnosis. Treatment outcomes in children with or
without health-insurance at diagnosis differed significantly (P=0.003). The most likely treatment outcome in children with
health-insurance at diagnosis was event-free survival (53%), whereas in children without health-insurance at diagnosis it was
abandonment of treatment (44%). The event-free survival estimate was significantly higher in children with health-insurance
at diagnosis than in patients without health-insurance at diagnosis (P=0.003). Age at diagnosis, gender, distance to hospital,
duration of symptoms and stage of disease did not significantly influence treatment outcomes and event-free survival estimates.
Conclusion: Survival of children with NHL in Kenya is much lower compared to high-income countries. Abandonment
of treatment was the most common cause of treatment failure. Health-insurance status at diagnosis significantly impacted
treatment outcomes and survival. Survival of children with NHL could increase if access to health-insurance would be
improved.