Abstract 51: Impacts of the COVID-19 Pandemic on Pediatric and Adolescent Cancer Care in Northern Tanzania
Authors: Rice Hannah , Majaliwa Esther , Cotache-Condor Cesia , Gwanika Yotham , Chao Nelson , Schroeder Kristin , Rice Henry , Staton Catherine , Mmbaga Blandina , Smith Emily 
Published: June 2023

Abstract
Purpose: Low- and middle-income countries (LMICs) have an increasing burden of pediatric cancer cases over recent years. In 2020, the COVID-19 pandemic further strained healthcare systems, presenting unique challenges for children requiring cancer care. The aim of this study was to assess differences in diagnoses, treatments, and outcomes of pediatric cancer patients before and during the COVID pandemic in Northern Tanzania.
Methods: In this cross-sectional study, we assessed the demographic and clinical characteristics of pediatric and adolescent cancer patients (ages 0-18 years old) between 2016 and 2021 using the population-based Kilimanjaro Cancer Registry (KMCR). We categorized data into pre-COVID (2016-2019) and COVID (2020-2021) eras to perform descriptive analysis of the diagnosis, treatment, and demographic information before and during the COVID pandemic. We conducted inferential statistical analyses to compare all demographic and clinical variables, and used chi-square statistics for categorical variables with significance set at p&lt;0.05. A secondary analysis was conducted on a subset of 101 children for whom cancer stage at diagnosis was recorded. This study received approval by the Kilimanjaro Christian Medical Centre (KCMC) and Duke University Institutional Review Boards and the National Institute for Medical Research.
Results: Among the 417 patients included in this study, a higher proportion of patients during the COVID pandemic were diagnosed with hematological malignancies (48.2%) compared to patients diagnosed during the pre-COVID era (42.9%). Rates of chemotherapy (71.7%) and radiotherapy (6.8%) were lower during the pandemic compared to pre-COVID cases (83.8% and 9.6%, respectively), while rates of surgical treatments increased from 14.6% to 19.6% after 2019. However, only rates of chemotherapy were significantly different between pre-COVID and COVID era cases.
Conclusion: Pediatric cancer care has changed in Tanzania during the COVID pandemic, with higher rates of hematologic malignancies and surgical therapies, but lower rates of chemotherapy and radiation therapy. Understanding the impact of the COVID pandemic on pediatric cancer care can help us better adapt healthcare systems and interventions to the emerging needs of children experiencing the compounding effects of cancer treatment and the global COVID crisis.
Citation Format: Hannah Rice, Esther Majaliwa, Cesia Cotache-Condor, Yotham Gwanika, Nelson Chao, Kristin Schroeder, Henry Rice, Catherine Staton, Blandina Mmbaga, Emily Smith. Impacts of the COVID-19 Pandemic on Pediatric and Adolescent Cancer Care in Northern Tanzania [abstract]. In: Proceedings of the 11th Annual Symposium on Global Cancer Research; Closing the Research-to-Implementation Gap; 2023 Apr 4-6. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(6_Suppl):Abstract nr 51.