High Mortality Rate Among Children and Adolescents with Cancer Treated in Burkina Faso

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Résumé

Data on childhood cancer mortality are scarce in Burkina Faso. We estimated pediatric cancer mortality and identified its
associated factors at the Yalgado Ouédraogo University Hospital Center (CHUYO) in Ouagadougou (Burkina Faso). We
conducted a retrospective cohort study of children under the age of 15 admitted for cancer and treated at CHUYO between March
1, 2014, and December 31, 2017. The cumulative incidence of mortality and its associated factors were estimated with the risk of
abandonment of treatment or follow-up as a competing risk. A total of 168 children/adolescents were included at a median age of
7 years (interquartile range [IQR]: 4–10 years); 71% were boys. The median follow-up duration was 4.51 person-months (IQR:
1.85-10.5). Burkitt lymphoma (77%) and retinoblastoma (21%) were the most common cancer. The majority of Burkitt
lymphoma (90%) were diagnosed at stage 3/4; the abdominal (58%) and maxillofacial (23%) locations were the most common.
All children/adolescents received chemotherapy and 10% received chemotherapy and surgery. No patients received
radiotherapy. During follow-up, overall mortality was 46%, and the risk of abandonment was 39%. The cumulative incidence of
mortality was 30, 43, and 45 per 100 person-months at 6, 12, and 24 months, respectively. In multivariate analysis, male gender
(adjusted sub hazard ratio [aSHR]: 2.20; 95%CI: 1.13-4.27), abdominal localization (aSHR: 2.68; 95%CI: 1.24-5.78),
maxillofacial and abdominal localization (aSHR: 3.39; 95%CI: 1.42-8.09) increased significantly the risk of death among
children and adolescent treated for Burkitt lymphoma. Early diagnosis and improved access to treatment are essential for better
survival rates among children and adolescents with cancer in Burkina Faso.

Mots-clés

Childhood Cancers, Mortality, Associated Factors, Burkina Faso