{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,25]],"date-time":"2026-07-25T21:15:05Z","timestamp":1785014105293,"version":"3.55.0"},"reference-count":39,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2024,9,23]],"date-time":"2024-09-23T00:00:00Z","timestamp":1727049600000},"content-version":"vor","delay-in-days":22,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Health Science Reports"],"published-print":{"date-parts":[[2024,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and Aim<\/jats:title><jats:p>Globally, over 180,000 children develop cancers yearly, with about 80% residing in low\u2010 or middle\u2010income countries where cancer\u2010associated mortality is also high. In The Gambia, cumulative incidence rate of 27.6 childhood cancers\/million population was reported between 2002 and 2011. The current study appraised newly\u2010established pediatric oncological services in The Gambia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In this prospective registry study, children with cancer who presented at the pediatric units, Edward Francis Small Teaching Hospital, Banjul, between November 2022 and October 2023 were assessed. Data on sociodemographic variables, mode of admission and presentation, tumor type, diagnostic methods, and challenges such as laboratory support, treatment, use of blood\/blood products; and eventual outcome were analyzed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The median (interquartile range, IQR) age at presentation of the 44 children was 36.0 (22.3\u2013117.0) months. Wilms tumor was the most common tumor 12 (27.3%); followed by leukemia 11 (25.0%); germ cell tumor 8 (18.2%); lymphoma 6 (13.6%); retinoblastoma 4 (9.1%); rhabdomyosarcoma 2 (4.5%) and one central nervous system tumor (2.3%). The median(IQR) duration of symptoms before presentation was 48 (21\u201390) days, presentation to diagnosis 7.5 (3\u201320.8) days, and first symptom to diagnosis 62.5 (32\u2013126.8) days. Treatment refusal and abandonment rates were 20.5% and 13.6%, respectively. Families of 93.8% of children could not procure cytotoxic drugs due to nonavailability, high cost, or both. Adequate laboratory monitoring was only available in 6.8%, and none had platelet concentrate transfusion or radiotherapy. The nine (20.5%) who completed treatment are currently being followed up, 10(22.7%) are still receiving chemotherapy, while 2(4.5%) were referred. Eight (18.2%) died, predominantly from metastasis (75%) and severe drug toxicities (25%).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Late presentation and diagnosis, poverty, unavailability of drugs, suboptimal or lack of laboratory testing, blood product, adjuvant medications, and psychosocial supports contributed to high treatment refusal, abandonment, and mortality. These daunting challenges can be ameliorated with regular community sensitization, frequent cancer auditing, and strong political will.<\/jats:p><\/jats:sec>","DOI":"10.1002\/hsr2.70084","type":"journal-article","created":{"date-parts":[[2024,9,24]],"date-time":"2024-09-24T05:14:26Z","timestamp":1727154866000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["A prospective registry study of the epidemiology and management of childhood cancer in the Gambia\u2014The first year experience"],"prefix":"10.1002","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8382-5758","authenticated-orcid":false,"given":"Samuel","family":"Adegoke","sequence":"first","affiliation":[{"name":"Department of Paediatrics Edward Francis Small Teaching Hospital (EFSTH) Banjul The Gambia"},{"name":"Department of Paediatrics Obafemi Awolowo University Ile\u2010Ife Nigeria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cherno","family":"Jallow","sequence":"additional","affiliation":[{"name":"Department of Surgery, Paediatric Surgical Unit EFSTH Banjul The Gambia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olufunmilola","family":"Ogun","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology Sheikh Zayed Regional Eye Care Centre Kanifing The Gambia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wuday","family":"Camara","sequence":"additional","affiliation":[{"name":"Department of Paediatrics Edward Francis Small Teaching Hospital (EFSTH) Banjul The Gambia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Musa","family":"Jaiteh","sequence":"additional","affiliation":[{"name":"Department of Paediatrics Edward Francis Small Teaching Hospital (EFSTH) Banjul The Gambia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Mendy","sequence":"additional","affiliation":[{"name":"Department of Paediatrics Edward Francis Small Teaching Hospital (EFSTH) Banjul The Gambia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriel","family":"Ogun","sequence":"additional","affiliation":[{"name":"Department of Anatomic Pathology, Histopathology Unit EFSTH Banjul The Gambia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ousman","family":"Leigh","sequence":"additional","affiliation":[{"name":"Department of Anatomic Pathology, Histopathology Unit EFSTH Banjul The Gambia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barry","family":"Pizer","sequence":"additional","affiliation":[{"name":"Paediatric oncology Division University of Liverpool Liverpool UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,9,23]]},"reference":[{"key":"e_1_2_10_2_1","unstructured":"St. Baldrick's Foundation.2016. 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