The survey, which gathered responses from 300 clinicians at hospitals in 79 countries during summer 2020, found that the disruptions in LMICs – which represented 83 per cent of the facilities surveyed – were more serious than in richer countries.
Problems including staffing, delays and a lack of beds and personal protective equipment were reported globally. But the effects in LMICs were more pronounced, with chemotherapy shortages and disruptions to radiotherapy, as well as more “treatment abandonment” – the term for delays to starting treatment or treatment not beginning at all.
For example, 40 per cent of hospitals in low income countries reported changes in chemotherapy services due to treatment agent shortages, but only 11 per cent of hospitals in high income countries. Unexpected deaths were also reported in 31 per cent of the low-income settings – where childhood cancer survival rates were already far lower even pre-pandemic – but only eight per cent in richer countries.
Funding cuts were also more common in poorer countries, and the disruptions in care did not seem to be linked to the number of Covid-19 cases a hospital, or country, had, the research found.
However, the authors noted some limitations to the study. It was conducted in English, meaning low-resource settings where staff do not speak the language or are not part of global paediatric oncology networks may not be represented.
There were some small positives reported among the generally gloomy picture: for example, almost two-thirds of hospitals put in place new processes for communicating with patients and families, which many said could be beneficial post-pandemic.
Professor Laila Hessissen, of Mohammed V University, Morocco, said: “Although the Covid-19 pandemic has created additional barriers to childhood cancer care, we have proven we are a resilient community and can translate some of the adaptations forced by the pandemic to the future of cancer care.”
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