{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T10:04:33Z","timestamp":1753869873043,"version":"3.41.2"},"reference-count":30,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2024,11,21]],"date-time":"2024-11-21T00:00:00Z","timestamp":1732147200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Blood &amp; Cancer"],"published-print":{"date-parts":[[2025,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The survival of children with Burkitt lymphoma (BL) in sub\u2010Saharan Africa is disproportionately low compared to high\u2010income countries. In Malawi, many of these children are diagnosed in advanced stages. Early and accurate diagnosis is critical to survival of children with BL. This qualitative study evaluates factors influencing health\u2010seeking decisions of guardians of children with BL in Northern and Central Malawi.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We conducted in\u2010depth interviews of guardians of children (&lt;18\u00a0years) diagnosed with BL and admitted to the Pediatric Oncology Unit at Kamuzu Central Hospital, in Lilongwe, Malawi, from February to April 2023. Participants were identified using purposive sampling. Data were analyzed using thematic content analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Twenty guardians participated in the interviews. The median age of the respondents was 41\u00a0years, and 65% were females. Four main themes emerged as factors influencing health\u2010seeking behaviors as guardians of children with BL navigated the Malawi health system. These included personal, economic, access to healthcare, and social factors. Financial status consistently emerged as a crucial determinant in the health\u2010seeking behaviors of guardians, but thematic analysis also revealed <jats:italic>knowledge and awareness<\/jats:italic>, geographical accessibility, and <jats:italic>symptom interpretation as key factors<\/jats:italic> shaping health\u2010seeking behaviors <jats:italic>for guardians of children with BL<\/jats:italic>. Symptom interpretation was influenced by the limited knowledge of the disease, and the lack of general awareness about childhood cancer.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>We identified financial and non\u2010monetary barriers affecting health\u2010seeking behavior among guardians of children with BL in Malawi. Targeted initiatives to alleviate the economic burden of cancer on affected families and increased awareness campaigns in the community are critical to improving BL outcomes in Malawi and other low\u2010resourced settings.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pbc.31442","type":"journal-article","created":{"date-parts":[[2024,11,22]],"date-time":"2024-11-22T05:45:10Z","timestamp":1732254310000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Factors Influencing Guardians' Health\u2010Seeking Decisions for Children With Burkitt Lymphoma in Northern and Central Malawi"],"prefix":"10.1002","volume":"72","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-6628-5424","authenticated-orcid":false,"given":"Hellen Rahma","family":"Mbutuka","sequence":"first","affiliation":[{"name":"Baylor College of Medicine Children's Foundation  Lilongwe Malawi"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gugulethu","family":"Mapurisa","sequence":"additional","affiliation":[{"name":"University of Witwatersrand  Johannesburg South Africa"},{"name":"University of North Carolina  Lilongwe Malawi"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7809-7699","authenticated-orcid":false,"given":"Rizine","family":"Mzikamanda","sequence":"additional","affiliation":[{"name":"Baylor College of Medicine Children's Foundation  Lilongwe Malawi"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marilyn","family":"Hockenberry","sequence":"additional","affiliation":[{"name":"Department of pediatrics Baylor college of medicine  Houston USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nmazuo W.","family":"Ozuah","sequence":"additional","affiliation":[{"name":"Department of pediatrics Baylor college of medicine  Houston USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eric","family":"Umar","sequence":"additional","affiliation":[{"name":"School of Global and Public Health Kamuzu University of Health Sciences  Blantyre Malawi"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,11,21]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1155\/2018\/6265182"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13256\u2010017\u20101548\u20100"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13027\u2010019\u20100236\u20107"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1200\/JGO.19.00172"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjh.13986"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1182\/bloodadvances.2020002178"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/mpo.10190"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12885\u2010019\u20105279\u2010z"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1186\/1750\u20109378\u20108\u201036"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.4314\/mmj.v20i4.10971"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1182\/bloodadvances.2018029199"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.11648\/j.ajtas.20160501.11"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1177\/1049732317697102"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1177\/1744987120927206"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.2044\u20108287.2012.02077.x"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1080\/13814788.2017.1375092"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.3390\/IJERPH13111140"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1155\/2018\/5190287"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12887\u2010020\u20101913\u20109"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12887\u2010018\u20101196\u20106"},{"key":"e_1_2_11_22_1","doi-asserted-by":"crossref","unstructured":"E. 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