Paediatric cancer burden in Namibia: A 10-year retrospective, analytical cohort study of patients admitted at Windhoek Central Hospital

PLOS ONE RESEARCH ARTICLE Paediatric cancer burden in Namibia: A 10year retrospective, analytical cohort study of patients admitted at Windhoek Central Hospital Ndapewa Ottilie Kaholongo ID1*, Runyararo Mashingaidze-Mano ID2 a1111111111 a1111111111 a1111111111 a1111111111 a1111111111 1 School of Medicine, Faculty of Medicine and Veterinary Sciences, University of Namibia, Windhoek, Namibia, 2 Division of Paediatrics, Department of Maternal and Child Health, School of Medicine, Faculty of Medicine and Veterinary Sciences, University of Namibia, Windhoek, Namibia * Abstract OPEN ACCESS Citation: Kaholongo NO, Mashingaidze-Mano R (2023) Paediatric cancer burden in Namibia: A 10year retrospective, analytical cohort study of patients admitted at Windhoek Central Hospital. PLoS ONE 18(11): e0292794. https://doi.org/ 10.1371/journal.pone.0292794 Editor: Nontuthuzelo Iris Muriel Somdyala, South African Medical Research Council, SOUTH AFRICA Received: May 23, 2023 Accepted: September 28, 2023 Published: November 16, 2023 Peer Review History: PLOS recognizes the benefits of transparency in the peer review process; therefore, we enable the publication of all of the content of peer review and author responses alongside final, published articles. The editorial history of this article is available here: https://doi.org/10.1371/journal.pone.0292794 Copyright: © 2023 Kaholongo, MashingaidzeMano. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Data Availability Statement: All relevant data are within the paper and its supporting information files, and additional data can be found in the Background Childhood cancers are known to cause significant morbidity and mortality, and the incidence has been increasing exponentially in developing countries. Two studies performed in Namibia in 1988 and 2010 have shown changes in the pattern of paediatric cancers over the years. There is a constant need to have updated statistics on the changing trends in the frequency of different types of cancers to inform policy hence the reason for the current study. Methods An analytical retrospective cohort study was performed to analyse paediatric oncology cases that were admitted to the paediatric oncology unit (ward 8 west) at Windhoek Central Hospital (WCH) between 01 January 2011 and 31 December 2020. The study analysed the files of paediatric patients admitted with a paediatric cancer diagnosis from the age of 0 to 16 years. The research data was collected between July 2021 and September 2022. Results A total of 174 paediatric cancer patient files met the inclusion criteria. Haematopoietic cancers were the most commonly occurring diagnosis of a paediatric cancer type in the study population (44.8%), of which leukaemias were the most common type of haematopoietic cancer. The other types of cancer apart from haematopoietic cancers consisted of embryonal cancers (37.9%), soft tissue and bone sarcomas (13.8%), and brain or CNS cancers (3.4%). The median age at diagnosis was 5.13 years, with an age range of 0 to 15 years. Fifty five point seven percent (55.7%) were males and 44.3% were females, with a male: female ratio of 1.26:1. Overall, most of the cancers were positively correlated with age, with the interactive-forward test indicating that the method of diagnosis and time significantly (P < 0.05) affected identification at the hospital. PLOS ONE | https://doi.org/10.1371/journal.pone.0292794 November 16, 2023 1 / 18 PLOS ONE following link: https://zenodo.org/badge/DOI/10. 5281/zenodo.8270769.svg. Funding: The authors received no specific funding for this work. Competing interests: The authors have declared that no competing interests exist. Abbreviations: CDC, Centers for Disease Control; CNS, Central nervous system; CT, Computed tomography; HIV, Human Immunodeficiency Virus; HIV/AIDS, Human Immunodeficiency Virus/ Acquired Immune Deficiency Syndrome; MOHSS, Ministry of Health and Social Services; MRI, Magnetic Resonance Imaging; PMTCT, Prevention of Mother to Child Transmission; SPSS, Statistical Package for Social Sciences; Std, Standard; WCH, Windhoek Central Hospital; WHO, World Health Organization. A retrospective, analytical cohort study done to analyse the paediatric oncology admissions Conclusions Haematopoietic cancers remain most common type in Namibia. However, there has been a change in the ranking of the other childhood cancer subtypes over the last 3 decades. Good access to diagnosis and treatment modalities was noted as key to detection and clinical outcomes in the last 10 years (2011 to 2020). For future follow-up studies, prospective studies are recommended. Background Childhood or paediatric cancers are known to cause significant morbidity and mortality and are the leading cause of death in children under 19 years of age [1]. Each year an estimated 400 000 children and adolescents of 0 to 19 years develop cancer [2]. Many of these cases (approximately 70%) occur in developing countries. While there are no age-specific cancers in the paediatric age group, there are certain cancers that present in specific childhood years [3]. The most common types of childhood cancers include leukemias, brain cancers, lymphomas and solid tumours, such as neuroblastoma and Wilms tumours [2, 4]. A study performed in Zimbabwe examined the pattern of paediatric cancers in children aged 0–14 years who were registered in the Zimbabwean Cancer Registry from 2000 to 2009 [5]. The study found that there was a prevalence of childhood cancer of 3.8% of all the malignancies recorded at the Zimbabwe National Cancer Registry over a ten-year period. The most common cancers were nephroblastoma, retinoblastoma and Kaposi sarcoma. Haematological cancers, specifically leukaemia and lymphomas, were also prevalent but were not the most common cancers [5]. Namibia a diverse nation of approximately 2.59 million people [6] had an estimated number 11 248 Namibians diagnosed with a malignant neoplasms in the last Namibian National Cancer Registry in 2014 [7]. Children under 15 years diagnosed with cancer constituted 3.3% [7]. However, it is known that in many African developing countries, such as Namibia, this estimate could be higher due to underdiagnoses or misdiagnosis of paediatric cancers [8]. In Africa, the incidence rates of some childhood cancers are much higher than those in developed countries [8]. Childhood cancer is curable [1], and in high-income countries, where comprehensive services are generally accessible, more than 80% of children with cancer are cured. In low- and middle-income countries (LMICs), less than 30% are cured [4, 9]. Stefan [8] suggests that the survival rate of paediatric cancers in Namibia was a mere 17%, in comparison to the higher rates in Western countries, such as the United States, where th (...truncated)