Assessment of the management and outcome of neutropenia in paediatric haemato-oncology inpatients at Kenyatta National Hospital

Abstract

Background: Neutropenia is a common complication among the haemato-oncology pediatric patients. Children who develop such complications are prone to bacterial infections which further predispose them to death. This study aimed at improving the practice of management of neutropenia in children with the view of reducing pediatric haemato-oncology mortality. Methods: We retrospectively reviewed medical records of paediatric haemato-oncology inpatients aged 13 years and below, who developed neutropenia during treatment at Kenyatta National Hospital. A data abstraction form was used to collect data from 113 medical records of patients admitted between 1st January 2020 and 31st December 2020. Data were analyzed using R to obtain descriptive and inferential statistics using a 95% confidence interval. Results: Boys constituted most of the cases assessed. The median (IQR) age at admission was 6 (4, 10) years. Leukaemias were more common than lymphomas. Acute lymphocytic leukaemia (59%) and Hodgkin’s lymphoma (4%) were the most and least frequently diagnosed haemato-oncology cancers. Most patients were diagnosed during the induction stage, 47 (42%) and had febrile neutropenia 59 (52%). Vaccination and bone marrow suppression histories were poorly documented. Thirty-three (29%) patients were reported to have succumbed during their treatment. G-CSF prescription was statistically significantly associated (p=0.045) with the survival status (death or alive) of patients, particularly at the induction stage (p=0.007). Conclusions: Neutropenia management in KNH is done as per protocol, with room to improve on history taking. Although 29% of the children succumbed within the course of treatment, the majority (71%) of the patients were discharged.