The project aims to improve diagnosis, treatment and care of children with cancer at the Queen Elizabeth Central Hospital in Blantyre, Malawi.
Dr Israels with Ganizano Amos - half way through his treatment for Burkitts lymphoma
Childhood cancer is curable children in Malawi in many cases yet fewer than 10% survive and only around a fifth of the expected cases are diagnosed. Furthermore, many of these children die without any effective pain relief. Currently around 220 children are diagnosed every year with cancer at the Queen Elizabeth Central Hospital. Over the last couple of years progress has been made in developing locally appropriate treatment protocols but there are not enough specially trained doctors and nurses to administer these protocols. In addition, there is a lack of data on children with cancer in Malawi making it difficult to assess the overall problem or conduct research.
- To increase survival rates for easily treatable cancers to 25% over 22 months.
- To develop specialist expertise in paediatric oncology of doctors and nurses.
- To provide accurate medical and personal information on child cancer patients in southern Malawi and accurate statistical data on the overall problem.
- To implement a training programme for doctors and nurses in curative treatment protocols.
- To provide mentoring via virtual meetings on weekly basis.
- To implement a training programme for doctors and nurses in palliative care.
- To establish a registry of child cancer patients to improve research.
- To improve follow up of patients at 6 and 12 months post treatment.
Project Update Report
Funding from International Health Links Funding Scheme started in August 2010. After the first 12 months of the project, World Child Cancer, the project co-ordinator, is delighted to report that good progress has been made.
1. Survival Rates - Although it is too early to accurately assess survival rates (assessment is based on 12 months event free survival after the completion of treatment) there are some encouraging signs. Survival rates for Burkitts lymphoma appear to be approaching 60% and a new protocol for acute lymphoblastic leukeamia is producing some encouraging response rates where previously there was no treatment available. Survival rates for Wilms tumour patients also appear to be approaching 35% after a new protocol was introduced. Furthermore, families are less likely to decline treatment due to improved practical and social support.
2. Development of specialist expertise in paediatric oncology amongst healthcare professionals - A series of workshops and talks have been held by Professor Molyneux and Dr Bailey (Newcastle based) and Dr Trijn (Amsterdam based) during visits in 2010 and 2011. These workshops have benefited approximately 20 healthcare professionals. A Nurse Educator from Newcastle visited in June 2011 to provide one to one training for 5 paediatric oncology nurses as well as training for the Malawian Nurse Educator. Professor Molyneux has visited the paediatric oncology unit at the Royal Victoria Infirmary, Newcastle, to update herself on advances in treatment and care.
3. Collection of accurate medical and personal information about child cancer patients - A specialist child cancer database has been identified and a visit by a Dutch expert to provide training to Professor Molyneux and her team will take place in August/September. A database manager will be trained and supported as part of the project. Data from existing patients will be transferred onto the new database. The database is essential for monitoring progress and identifying issues which impact on survival including families declining treatment, toxic death rates and early relapses.
Professor Molyneux examining a patient by ultrasound
The link between the Queen Elizabeth Central Hospital (Blantyre, Malawi) and Royal Victoria Infirmary (Newcastle, UK) remains strong with weekly teleconference or email communication between Professor Molyneux and Drs Bailey and Skinner. These sessions focus on discussion of individual cases and development of locally appropriate treatment protocols.
Work has begun to identify long-term funding partners for the project to ensure sustainability in the long-term. World Child Cancer is working with the Non-Communicable Disease Alliance to raise awareness of the problem of child cancer in low and middle income countries to encourage other health funders to focus on the problem. The collection of statistical data will help to demonstrate that significant improvements in survival rates can be made and sustained with relatively low levels of funding.
The project is looking for donations to fund the cost of chemotherpay and palliative care drugs.
Prof Elizabeth Molyneux
Queen Elizabeth Central Hospital
The project is being project managed in the UK by World Child Cancer, a charity which works to improve curative and palliative care for children with cancer in low and middle income countries through the development of international twinning partnerships between medics and hospitals.
Contact: Jo Hopkins, Chief Executive
Tel: 020 3176 4490
Address: Southbank House, Black Prince Road, London SE1 7SJ