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Wilms' tumour in African children: Can an institutional approach improve outcome?
Lofty-John Chukwuemeka Anyanwu, Lofty-John Chukwuemeka Anyanwa, Akinfenwa Taoheed Atanda1
1Department of Pathology, Bayero University/Aminu Kano Teaching Hospital, Kano, Nigeria.
Insights
An institutionalized approach improved Wilms' tumour (WT) outcomes in Nigerian children by increasing chemotherapy access and reducing patient loss. This strategy enhanced survival rates, demonstrating the impact of structured care in developing nations.
Area of Science:
- Pediatric Oncology
- Global Health
Background:
- Wilms' tumour (WT) outcomes are poor in developing countries due to late diagnosis and limited chemotherapy access.
- An institutionalized approach was implemented in a Nigerian tertiary hospital to address these challenges.
Purpose of the Study:
- To evaluate the impact of an institutionalized care model on Wilms' tumour patient outcomes in Nigeria.
- To assess therapy completion and survival rates in comparison to other African centers.
Main Methods:
- Retrospective analysis of pediatric oncology records for Wilms' tumour (WT) cases from 2009-2013.
- Comparison of treatment completion and prognostic factors with data from other African institutions.
Main Results:
- Achieved a 60% therapy completion rate, higher than many local and African studies.
- Observed survival rates between 1 and 4 years.
- Ensured no patients were lost to follow-up due to drug unavailability or cost.
Conclusions:
- An institutionalized approach significantly improves access to anti-cancer drugs and reduces patient attrition.
- Enhanced patient outcomes for Wilms' tumour (WT) through structured management.
- Recommended improvements include enhanced patient-doctor communication, support groups, and a WT registry.
Background:
The poor outcome for patients with Wilms' tumour (WT) in developing countries has been predicated on late presentation, poverty and low rate of chemotherapeutic access. This study aims to evaluate the effects of an institutionalised approach to improving outcome for patients managed in a tertiary hospital in Nigeria.
Materials And Methods:
Oncology records of children diagnosed with WT between 2009 and 2013 were analysed for therapy completion and other prognostic parameters. Ensuing data were then compared with those from other centres in Africa.
Results:
Compared with results from some local and African studies, the therapy completion rate was higher (60%) with a survival rate among this group being between 1 and 4 years. No patient was lost to follow-up because of unavailability or unaffordability of cytotoxic agents.
Conclusion:
This study shows that an institutionalised approach can help to improve access to anti-cancer drugs, reduce the rate of loss to follow-up and thus improve outcome. There is however need to improve on patient-doctor communication, form support groups and establish a WT registry.
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