Characterizing pediatric CNS tumors in Nigeria: A systematic review

Nigeria, the most populous country in Africa, has the highest incidence of central nervous system (CNS) tumors on the continent, yet faces limited access to neuro-oncology care, particularly for pediatric patients. Given the sparse literature on pediatric neuro-oncology in the country, this study provides an epidemiologic overview of the presentation, diagnosis, treatment, and outcomes of pediatric CNS tumor cases in Nigeria.

We conducted a systematic review across six databases, covering January 1962 to December 2023, including articles specifically addressing pediatric CNS tumor care in Nigeria. Extracted variables included demographics, presentation, diagnostics, treatment, complications, and outcomes.

Twenty-nine studies met the inclusion criteria, encompassing 507 pediatric patients (56.6% male) with a mean age of 8.68 years (SD: 4.32). Headache (27.2%) was the most common presenting symptom. Diagnostic imaging included MRI (34.7%), CT (26.4%), and X-ray (8.9%), with all diagnoses histologically confirmed. Surgical resection was the most common treatment (40.2%), while a few patients received systemic therapy. Hydrocephalus was the most frequently reported complication. The post-intervention mortality rate was 13%, and the five-year mortality rate was 11%.

Pediatric CNS tumors in Nigeria present with diverse symptoms and are primarily managed surgically. Despite access to modern diagnostics, outcomes remain suboptimal, underscoring the need for improved infrastructure, timely diagnosis, and standardized care pathways to enhance pediatric neuro-oncology outcomes in Nigeria.