Browsing by Author "Stefan, D. C."

Now showing 1 - 5 of 5
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    Childhood cancer in Cote d'Ivoire, 1995-2004 - challenges and hopes
    (Health & Medical Publishing Group, 2013) Yao, J. J. A.; Couitchere, L.; Atimere, Y.; Kone, D.; Azagoh-Kouadio, R.; Oulai, M. S.; Stefan, D. C.
    Background. There is insufficient research into the state of paediatric oncology in African countries. Objectives. The purpose of this study was to analyse the state of paediatric oncology between 1995 and 2004 in Côte d’Ivoire. Methods. This retrospective descriptive study analysed all patients under the age of 18 who were diagnosed with cancer in Côte d’Ivoire over a period of 10 years (January 1995 - December 2004) with regard to demographics, types of pathology, delay in diagnosis and treatment, treatment modalities, abandonment of treatment and survival rate. Results. Of 405 patients diagnosed with cancer, 331 were included in the study. Burkitt’s lymphoma was the most common malignancy (73.6%), followed by nephroblastoma (14.5%) and acute leukaemia (4%). Delay in diagnosis occurred in 38.7% of cases and ranged from 1 to 3 months; the average delay from diagnosis to starting treatment was 18 days. An abdominal mass and swelling of the jaw were the most common clinical presentations. Almost half of the patients (48.6%) were lost to follow-up and over a third (39.3%) died shortly after admission owing to advanced disease. The overall survival rate was 9.4%. Conclusions. Cancer in children in Côte d’Ivoire was dominated by Burkitt’s lymphoma. The rate of loss to follow-up of almost 50% is grounds for concern. The overall survival rate of 9.4% is very low, but such figures are not uncommon for African countries. Collaboration within the Franco-African Group of Paediatric Oncology has contributed to improving the management of children with cancer.
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    Childhood cancer incidence in South Africa, 1987 - 2007
    (Health & Medical Publishing Group, 2015) Stefan, D. C.; Stones, D. K.; Wainwright, D.; Kruger, Mariana; Davidson, A.; Poole, J.; Hadley, G. P.; Forman, D.; Colombet, M.; Steliarova-Foucher, E.
    Background. Childhood cancer is an emerging problem in Africa. Its extent is hazy because data are scarce, but it should be addressed. This is the first report from the South African Children’s Tumour Registry (SACTR), which covers the whole of South Africa (SA). It provides minimal estimates of cancer incidence and discusses the challenges of cancer surveillance and control in a child population in a middle-income country. Only about 2% of the African population is covered by cancer registries producing comparable incidence data. Objective. To present and interpret incidence patterns and trends of childhood cancer over a 21-year period. The results should raise awareness of the problem of childhood cancer in an African population and provide sensible data for taking this problem in hand. Methods. All eligible and validated cancer cases registered in the SACTR over the period 1987 - 2007 and classified according to the International Classification of Childhood Cancer were included. Population data were retrieved from official sources and estimated for the population subcategories. Incidence rates were standardised to the world standard and time trends were evaluated using joinpoint models, adjusting for sex and age. Results. Based on the 11 699 cases, the overall age-standardised average annual incidence rate was 45 per million. Threefold differences in the overall incidence rates were observed between the ethnic groups, ranging from 116 for whites to 37 for black Africans, and they differed by diagnostic group. Differences between the nine provinces of SA relate to the ethnic composition and prevailing socioeconomic status. The overall incidence rate declined by 1.2% per year for the whole country (p<0.01). However, the decline was mainly observed during the first few years of the study period, after which rates stabilised or increased. Conclusions. Diagnosis and notification of childhood cancer should improve. The differences in incidence between ethnic groups suggest the priorities for cancer control.
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    Children with Kaposi sarcoma in two Southern African hospitals : clinical presentation, management, and outcome
    (Hindawi, 2013) De Bruin, G. P.; Stefan, D. C.
    In 2010 more than 3 million children with human immunodeficiency virus (HIV) were living in Sub-Saharan Africa. The AIDS epidemic has contributed to an abrupt increase of the frequency of Kaposi sarcoma (KS), especially in Southern Africa. There is a need to describe the clinical features of this disease, its management, and its outcome in HIV positive children in Southern Africa. The aim of the study is to describe two different populations with HIV and KS from two African hospitals in Namibia and South Africa. Material and Methods. A retrospective descriptive study of patients with KS who presented to Tygerberg Hospital (TH) and Windhoek Central Hospital (WCH) from 1998 to 2010. Demographic data, HIV profile, clinical picture of KS, and survival were documented. Results. The frequency of KS declined from 2006 to 2010 in TH but showed an increase in the same period in WCH. Children in TH were diagnosed at a much younger age than those in WCH (44.2 months versus 90 months). Cutaneous lesions were the most common clinical presenting feature, followed by lymphadenopathy, intrathoracic and oral lesions. Conclusions. The clinical characteristics of KS in South Africa and Namibia differ in many aspects between the 2 countries.
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    Twinning in paediatric oncology : an African experience
    (Health & Medical Publishing Group, 2012) Stefan, D. C.; Shalongo, S.; Ribeiro, R.
    Developing twinning programmes in paediatric oncology between African countries is possible, encouraging and rewarding. The development of centres of excellence in Africa could serve as a means of disseminating the knowledge and channelling international support for the surrounding countries in their effort to cure children’s cancer.
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    An update on the management of breast cancer in Africa
    (BioMed Central, 2017-02-14) Vanderpuye, V.; Grover, S.; Hammad, N.; Prabhakar, Pooja; Simonds, H.; Olopade, F.; Stefan, D. C.
    ENGLISH SUMMARY : Background: There is limited information about the challenges of cancer management and attempts at improving outcomes in Africa. Even though South and North Africa are better resourceds to tackle the burden of breast cancer, similar poor prognostic factors are common to all countries. The five-year overall Survival rate for breast cancer patients does not exceed 60% for any low and middle-income country (LMIC) in Africa. In spite of the gains achieved over the past decade, certain characteristics remain the same such as limited availability of breast conservation therapies, inadequate access to drugs, few oncology specialists and adherence to harmful sociocultural practices. This review on managing breast cancer in Africa is authored by African oncologists who practice or collaborate in Africa and with hands-on experience with the realities. Methods: A search was performed via electronic databases from 1999 to 2016. (PubMed/Medline, African Journals Online) for all literature in English or translated into English, covering the terms “breast cancer in Africa and developing countries”. One hundred ninety were deemed appropriate. Results: Breast tumors are diagnosed at earlier ages and later stages than in highincome countries. There is a higher prevalence of triple-negative cancers. The limitations of poor nursing care and surgery, inadequate access to radiotherapy, poor availability of basic and modern systemic therapies translate into lower survival rate. Positive strides in breast cancer management in Africa include increased adaptation of treatment guidelines, improved pathology services including immuno-histochemistry, expansion and upgrading of radiotherapy equipment across the continent in addition to more research opportunities. Conclusion: This review is an update of the management of breast cancer in Africa, taking a look at the epidemiology, pathology, management resources, outcomes, research and limitations in Africa from the perspective of oncologists with local experience.