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Children deaths to cancer on rise, Mulago doctors say

Children cut cake to celebrate completion of treatment at the Mulago Children with Cancer Unit

Children cut cake to celebrate completion of treatment at the Mulago Children with Cancer Unit

Two physicians affiliated with the Children with Cancer Unit at Mulago hospital report a concerning trend: an increase in cancer cases among children, resulting in a staggering annual mortality rate of approximately 70 per cent.

Dr Anne Akullo, a pediatric hematologist and Associate director of Clinical Operations at the Global Hope programme, identifies late diagnosis and treatment discontinuation as key factors contributing to the dismal survival rates observed in pediatric cancer patients. The Global Hope programme is a worldwide initiative aimed at combating cancer among minors.

“In Uganda, there’s a prevailing belief that children are not susceptible to cancer; it’s seen as an ailment of adulthood. However, the reality is stark: approximately 7,000 children currently live with cancer, and each year, more than 1,000 children are diagnosed with the disease across all treatment centers in Uganda,” stated Dr Akullo during the International Childhood Cancer day at the Bless a Child Foundation in Makerere-Kikoni and the Mulago Children with Cancer Unit last week.

“Even the 7,000 diagnosed cases represent only about 10 per cent of those who should have been identified. Sadly, many succumb to the illness before reaching the hospital,” Dr. Akullo added.

Her colleague, Dr Annet Nakirulu, emphasized that the primary obstacle in combating childhood cancer is the lack of awareness among healthcare workers, parents and children.

“Some health workers and parents attribute cancers to witchcraft, while others are unaware due to various myths and misconceptions. Without an understanding of childhood cancer, parents may not recognize the symptoms, preventing timely diagnosis and treatment,” Dr Nakirulu explained.

“This lack of awareness often results in either no diagnosis or misdiagnosis. When diagnosed late, the chances of survival diminish significantly. Therefore, increasing awareness is crucial,” Nakirulu emphasized.

Both doctors noted that they have initiated community outreach programs to educate people about childhood cancers.

“If a child in the community exhibits symptoms related to cancer, such as swelling, but the community is unaware of the connection, they may seek healthcare in vain, leading to tragic outcomes,” Dr Akullo noted.

While the exact cause of childhood cancers remains unclear, risk factors such as infections, HIV, and hepatitis B, which compromise children’s immune systems, have been identified by specialists. Hepatitis B is linked to liver cancer, among other conditions.

According to the specialists, common symptoms such as unusual swellings, unexplained pain, persistent headaches, headaches accompanied by vomiting or convulsions, changes in handwriting or academic performance, may indicate an underlying health issue, possibly in the brain.

“When cancer has progressed extensively, it can affect any part of the body. It’s crucial to maintain a high level of suspicion. Childhood cancer is sometimes diagnosed late due to atypical symptoms,” Dr Akullo explained.

“Instead of resorting to attributing symptoms to witchcraft, it’s important to seek logical explanations for unexplained conditions,” she added.

The doctors emphasized that childhood cancer is treatable, with an 80 per cent survival rate in high-income countries. “Early diagnosis, appropriate treatment, and continuous care can make this achievable,” Dr. Nakirulu noted.

They highlighted February and September as months dedicated to raising awareness about childhood cancer, with this year’s theme being ‘closing the gap.’

The specialists stressed that community involvement is essential in bridging this gap, urging recognition, participation, destigmatization, and support for children with cancer.

Uganda currently has four cancer treatment facilities, including the 5th floor of the new Mulago Hospital, the Uganda Cancer Institute, Lacor Hospital in Gulu, and Mbarara regional referral hospital.

Mulago hospital houses the Early Childhood Pediatric Hematology and Oncology Unit, which provides inpatient and outpatient care for pediatric blood and cancer disorders, with a capacity of 48 beds.

Bless a Child Foundation aims to address challenges faced by children with cancer during treatment. Brian Walusimbi, the founder, emphasized that geographical location should not determine the quality of a child’s treatment or chances of survival. The foundation provides palliative care, accommodation, meals, transportation, and other forms of support to children whose parents are unable to regularly transport them for treatment.

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