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Background: Globally, there is an increase in the number of pediatric oncology cases with significant morbidity and mortality in the low to middle income countries (LMIC) despite improved survival in the resource endowed nations. The increase in survival is largely due to the revolutionary use of multi strategy therapeutic interventions like chemotherapy, immunotherapy, surgery and radiotherapy. These modalities are however fraught with several complications. AIM The aim of this study was to prospectively observe and document the common complications following treatment of childhood cancers in a tertiary pediatric oncology unit in a resource constrained setting. Methods: This was a longitudinal observational study over a three-year period involving children with various cancers. Ethical approval was obtained from the hospital's human, research and ethics committee. A questionnaire was used to obtain socio-demographic data as well as details of adverse events encountered. Results: A total of 100 children enrolled in the study with acute lymphoblastic leukaemia been the commonest cancer. Gastrointestinal adverse events were the most common in the study cohort with alopecia rarely reported. Conclusion: Increased awareness of the common complications in this environment and prophylactic medications may improve the care of children post chemotherapy thereby reducing overall morbidity and cost of care.

Background: Unaffordable health-care costs are a critical factor in poor cancer care in low and middle-income countries. Net costs of treating childhood cancer in Nigeria are largely undocumented. This study sought to define the direct cost of pediatric cancer treatment in Lagos, Nigeria, to address this knowledge gap. Methods: This was a longitudinal study design targeting determination of cost of cancer-related care delivered to newly diagnosed childhood cancer patients at the Lagos University Teaching Hospital, Idi-Araba, Lagos, Nigeria, from January 2017 to January 2020. Study participants included children with histologically confirmed diagnoses. All direct costs associated with care from the time of diagnosis until either remission or death were documented based on a parental survey at each patient encounter. Results: Among 46 enrolled participants (median age of 6 years), leukemia was the most common diagnosis. The median duration from diagnosis to last assessment was 11 months, and the average cost directly related from diagnosis to remission or death was NGN 5,064,700 (USD 13,876). The highest cost of care was associated with rhabdomyosarcoma, with an average cost of ₦6,798,635 ($18,678). These costs were juxtaposed to the average monthly family earning of NGN 115,228 (USD 316). Conclusion: This study revealed the direct cost of managing childhood cancer in Lagos, Nigeria, which proved unaffordable for most caregivers. Policies are needed to improve the affordability of health-care delivery for childhood cancer, including a focus on the adequacy of health insurance coverage and public health-related policies governing financial support targeting health-care delivery in the context of childhood cancer to improve outcomes.

Background: Sickle cell anemia (SCA) is the most prevalent genetic disease in the world and the most severe of the sickle cell disorders. Individuals with SCA undergo numerous psychosocial problems. The severity of the clinical status of SCA imposes differing degrees of suffering to patients and their relatives, and the overall health of these patients depends on the quality of life and psychological preparedness of the caregivers. This study assessed the knowledge of sickle cell disease (SCD) and the psychosocial burdens of the disease on caregivers. Methods: This was a cross-sectional study conducted at Massey Street Children Hospital. Following consent, an interviewer-administered structured pro forma was utilized for the survey. The study was approved by the Health, Research, and Ethics Committee with permission from the Lagos State Health Service Commission. Data were analyzed using Epi Info™ 7.140. Results: Two hundred and sixteen respondents were interviewed with a mean age of 37.7 ± 7.8 years. Most of the respondents were female (90.7%) and presently married (90.7%). The mean knowledge score was 7.5 ± 2.1, with most (74.1%) of the respondents having good knowledge. The vast majority of respondents had lost income or financial benefits due to time spent caring for the child (91.2%) and reported that a child's illness disturbs activities at home (77.3%). Almost all (96.8%) reported an atmosphere of tension in the homes due to a child's illness, 80.6% reported episodes of depression and feeling sorrowful, 34% felt angry with self or child, and 14.3% felt stigmatized because of child's illness. There was a statistically significant association between respondents' level of education, gender, age, relationship to a child, and knowledge of SCD, and a higher proportion of those with good knowledge had no disruption of family interactions. Conclusion: Majority of the caregivers accessing care for children with SCD had good knowledge of the disease and experienced varied degrees of disruption in their finances, family routine, and family interaction. Improving knowledge of SCD is recommended among caregivers to alleviate psychosocial burdens, especially those associated with family interactions.

Background: Cancers in children are increasing all over the globe, however, the outcome in LMICs is still quite poor due to a myriad of factors. Aim: This review focused on pattern of admissions in a pediatric oncology unit in Lagos, Nigeria and the determinants of outcome. Settings and Design: This was a retrospective descriptive study at the Lagos University Teaching Hospital from January 2015 to July 2017. Common treatment protocols like UKALL, NWTSG etc are adapted for use in the unit. Data Analysis: This was done using SPSS version 22. Results: A total of 178 children were seen at the oncology unit with a slight male preponderance of 1.4:1. The most common malignancy seen was acute lymphoblastic leukemia (20.8%) while retinoblastoma was the commonest solid tumor (19.6%). Mortality rate observed in the period under review was 45% and a large number of patients (22%) abandoned treatment. Conclusion: The management of childhood cancers is still a big challenge in resource constrained settings and a robust health insurance policy will improve outcomes.

Background: Retinoblastoma is the most common intraocular childhood malignancy. Its management is, however, not without challenges especially in a developing country like Nigeria. This study sought to present the clinical profile and treatment outcome of patients with retinoblastoma managed in a Nigerian tertiary eye care facility highlighting the challenges with a view to improving the management of the disease. Materials and Methods: A retrospective, single-institution, and institutional review board-approved review of all patients diagnosed with retinoblastoma between January 2012 and December 2015 was done. Data obtained from case files of patients include demographic characteristics, presenting complaint, laterality of disease, tumor stage using the International Intraocular Retinoblastoma Classification, treatment, and outcome. Information obtained from phone calls to the caregivers were also summarized. Results: The review included 54 eyes of 41 patients between the ages of 2 months and 5 years. The mean age at presentation was 24.4 ± 11.4 months. There were 18 males (43.9%). Duration of symptoms before presentation ranged from 2 weeks to 2 years. Tumor was bilateral in 13 (31.7%) patients. Leukocoria was the most common presenting complaint observed in 32 (59.2%) eyes. Groups D and E were the most common intraocular tumor stage documented in 16 (29.7%) and 15 (27.8%) eyes, respectively. Most patients (29, 70.7%) defaulted from treatment after the first or second presentation. Only 6 (21.4%) of 28 patients offered enucleation or modified exenteration either at presentation (Class E) or after chemoreduction (orbital disease) consented. Conclusion: Late presentation, high default rate, and noncompletion of treatment were the major challenges facing retinoblastoma management in this center.