ArticleSupportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer2023
Influence of health-insurance on treatment outcome of childhood cancer in Western Kenya.
Article in Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed.
- Prospective Cohort Study Testing Interventions to Reduce Diagnosis Delay and Treatment Abandonment of Children With Burkitt Lymphoma in Kenya.JCO global oncology · 2026Article
- Burden and quality of life among caregivers of children diagnosed with cancer at Kenyatta National Hospital, Kenya: A cross-sectional study.Palliative care and social practice · 2026Article
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- Investigator-Initiated Clinical Pharmacokinetic Studies in Resource-Limited Settings: Minimal Requirements and Practical Guidance.Journal of clinical pharmacology · 2025Review
- Parental Reports on Late Effects and Follow-Up Needs: A Single-Center Assessment of Childhood Cancer Survivorship Care in Kenya.Current oncology (Toronto, Ont.) · 2025Article
- Childhood Cancer Awareness Program in Bungoma County, Kenya.Journal of cancer education : the official journal of the American Association for Cancer Education · 2025Article
- Self-Reported Late Effects in Childhood Cancer Survivors in Kenya.African health sciences · 2024Article
- Financing for equity for women's, children's and adolescents' health in low- and middle-income countries: A scoping review.PLOS global public health · 2024Article
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10 authors.
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Abstract
backgroundFew governments in low and middle-income countries (LMIC) have responded favourably to the international plea for Universal Health Coverage. Childhood cancer survival in LMIC is often below 20%. Limited health-insurance coverage may contribute to this poor survival. Our study explores the influence of health-insurance status on childhood cancer treatment outcomes in a Kenyan academic hospital.
methodsThis was a retrospective medical records review of all children diagnosed with cancer at Moi Teaching and Referral Hospital between 2010 and 2016. Socio-demographic and clinical data was collected using a structured data collection form. Fisher's exact test, chi-squared test, Kaplan-Meier method, log-rank test and Cox proportional hazard model were used to evaluate relationships between treatment outcomes and patient characteristics. Study was approved by Institutional Research Ethics Committee.
findingsFrom 2010-2016, 879 children were newly diagnosed with cancer. Among 763 patients whose records were available, 28% abandoned treatment, 23% died and 17% had progressive/relapsed disease resulting in 32% event-free survival. In total 280 patients (37%) had health-insurance at diagnosis. After active enrolment during treatment, total health-insurance registration level reached 579 patients (76%). Treatment outcomes differed by health-insurance status (P < 0.001). The most likely treatment outcome in uninsured patients was death (49%), whereas in those with health-insurance at diagnosis and those who enrolled during treatment it was event-free survival (36% and 41% respectively). Overall survival (P < 0.001) and event-free survival (P < 0.001) were higher for insured versus uninsured patients. The hazard-ratio for treatment failure was 0.30 (95% CI:0.22-0.39; P < 0.001) for patients insured at diagnosis and 0.32 (95% CI:0.24-0.41; P < 0.001) for patients insured during treatment in relation to those without insurance.
interpretationOur study highlights the need for Universal Health Coverage in LMIC. Children without health-insurance had significantly lower survival. Childhood cancer treatment outcomes can be ameliorated by strategies that improve health-insurance access.
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