ArticleBMJ paediatrics open2017
Influence of health insurance status on paediatric non-Hodgkin's lymphoma treatment in Kenya.
Article in BMJ paediatrics open, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers.
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Who cites it
16 citing papers in PubMed.
- Using flow cytometry for paediatric leukaemia diagnosis in Kenya: a protocol for mixed methods study.BMJ open · 2026Article
- Prospective Cohort Study Testing Interventions to Reduce Diagnosis Delay and Treatment Abandonment of Children With Burkitt Lymphoma in Kenya.JCO global oncology · 2026Article
- Childhood cancer survival in low- and middle-income countries and the Global South: emerging evidence and critical gaps from a scoping review of observational studies.EJC paediatric oncology · 2025Review
- Article
- Childhood Cancer Awareness Program in Bungoma County, Kenya.Journal of cancer education : the official journal of the American Association for Cancer Education · 2025Article
- Cost-effectiveness and budget impact of covering Burkitt lymphoma in children under Ghana's National Health Insurance Scheme.Cost effectiveness and resource allocation : C/E · 2025Article
- Influence of health-insurance on treatment outcome of childhood cancer in Western Kenya.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2023Article
- Article
- Improvement of diagnosis in children with Burkitt lymphoma in Kenya: feasibility study for the implementation of fluorescenceEcancermedicalscience · 2023Article
- Outcomes of pediatric acute myeloid leukemia treatment in Western Kenya.Cancer reports (Hoboken, N.J.) · 2022Article
- The magnitude and perceived reasons for childhood cancer treatment abandonment in Ethiopia: from health care providers' perspective.BMC health services research · 2022Article
- Caregiver Acceptability of Mobile Phone Use for Pediatric Cancer Care in Tanzania: Cross-sectional Questionnaire Study.JMIR pediatrics and parenting · 2021Article
- Health Insurance in Sub-Saharan Africa: A Scoping Review of the Methods Used to Evaluate its Impact.Applied health economics and health policy · 2020Article
- Health insurance coverage for vulnerable children: two HIV orphans with Burkitt lymphoma and their quest for health insurance coverage in Kenya.BMJ case reports · 2020Article
- Seeking care in the context of social health insurance in Kenya and Ghana.BMC public health · 2020Article
- Patterns, treatments, and outcomes of pediatric central nervous system tumors in Sudan: a single institution experience.Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery · 2019Article
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Authors and funding
10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveNon-Hodgkin's lymphoma (NHL) is the most common childhood malignancy in sub-Saharan Africa. Survival rates for NHL are higher than 80% in high-income countries.This study explores treatment outcomes of children with NHL in Kenya, a sub-Saharan low-income country, and the association between health insurance status at diagnosis and treatment outcomes.
designThis was a retrospective medical records study. All children diagnosed with NHL in 2010, 2011 and 2012 were included. Data on treatment outcomes and health insurance status at diagnosis were collected.
resultsOf all 63 patients with NHL, 35% abandoned treatment, 22% had progressive or relapsed disease, 14% died and 29% had event-free survival. Most patients (73%) had no health insurance at diagnosis. Treatment outcomes in children with or without health insurance at diagnosis differed significantly (p=0.005). The most likely treatment outcome in children with health insurance at diagnosis was event-free survival (53%), whereas in children without health insurance at diagnosis it was abandonment of treatment (44%). Crude HR for treatment failure was 3.1 (95% CI 1.41 to 6.60, p=0.005) for uninsured versus insured children. The event-free survival estimate was significantly higher in children with health insurance at diagnosis than in patients without health insurance at diagnosis (p=0.003). Stage of disease at diagnosis was identified as a confounder of this association (adjusted HR=2.4, 95% CI 0.95 to 6.12, p=0.063).
conclusionsSurvival of children with NHL in Kenya is much lower compared with high-income countries. Abandonment of treatment is the most common cause of treatment failure. Health insurance at diagnosis was associated with better treatment outcomes and survival.
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