Establishing a Pediatric Hematology-Oncology Program in Botswana

Area of Science:

• Pediatric Oncology
• Global Health
• Cancer Epidemiology

Background:

• 300,000 children diagnosed with cancer annually, predominantly in low- and middle-income countries (LMICs).
• Limited data exists on pediatric cancer incidence, diagnosis, and outcomes in Africa.
• A pediatric hematology-oncology program established in Botswana in 2007 through international partnership.

Purpose of the Study:

• To assess patient characteristics and treatment outcomes at Botswana's sole pediatric cancer program.
• To establish a hospital-based database, the Botswana Pediatric Oncology Database, for comprehensive data collection.
• To analyze data from children diagnosed between 2008 and 2015.

Main Methods:

• Utilized the Botswana Pediatric Oncology Database, established in 2014.
• Included children under 18 diagnosed between 2008 and 2015.
• Extracted data in February 2016 for 185 eligible children (77% of potential enrollees).

Main Results:

• Leukemia was the most frequent malignancy (18.9%); 88.1% had histopathologic diagnosis.
• HIV seropositivity was present in 13.5% of the pediatric cancer cohort.
• The 2-year overall survival rate for all pediatric cancers was 52.4%; treatment abandonment was 3.8%.

Conclusions:

• A Botswana-based pediatric cancer program, supported by international partnerships, has successfully provided care for children with cancer and blood disorders.
• Outcomes demonstrate that children with cancer in Botswana can be effectively diagnosed and treated.
• Continued improvements are necessary, but current results show significant progress in pediatric oncology care in LMICs.