Abstract

Abstract BACKGROUND Central nervous system tumors are the most common solid tumors in children and the second commonest childhood cancer globally. We describe the establishment of the first dedicated comprehensive pediatric neuro-oncology treatment center that may serve as a model for others in low-resource settings and the impact of this initiative. METHODS This is a descriptive interim report of a pediatric neuro-oncology capacity building program in the SSA setting established in March 2019 at Mulago National Referral Hospital in Uganda, including a retrospective study conducted at Mulago National referral Hospital, in patients below 18 years of age admitted with a radiological diagnosis of a brain tumor from March 2019 to March 2023, to demonstrate the impact of this program. The program is a collaboration between Makerere University, Mulago National Referral Hospital, Texas children's Hospital/Baylor College of Medicine, and other academic and philanthropy partners in North America and Europe. RESULTS A total of 14 pediatric oncologists have been trained over 6 years, with one further training in neuro-oncology. Multidisciplinary management involving local experts from Uganda and experts from Texas Children's Hospital has been strengthened. Between March 2019 and March 2023, 121 children were diagnosed radiologically with brain tumors. Majority (57%) of these patients were males. The commonest symptom at presentation was headache (42%). Most of the patients (52%) had infratentorial tumors. The commonest diagnosis was glioma (38%), craniopharyngioma (26%), medulloblastoma (11%). Fifty-two patients had surgical resection and a histological diagnosis. Ten percent of patients had no diagnosis. Radiotherapy was received by 24(20%) patients. Twenty patients received chemotherapy. Sixty-six are alive and attending clinic. The overall one-year survival was 63%(95%CI(50.3-73.4). CONCLUSION Capacity to improve the suspicion, referral, diagnosis and comprehensive care for children with central nervous system tumors in low-resource settings can be improved through innovative collaborations.

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