Abstract:
Background: Pediatric brain tumors are understudied compared to other pediatric malignancies in low- and middle-income
countries. Care delivery is inherently dependent on collaboration between multiple departments. This study aimed to present
baseline data of pediatric neuro-oncology care in Western Kenya and illustrate barriers and facilitators of multidisciplinary care.
Methods: We performed a mixed-methods study using medical records and interviews. Children below age 19 years, managed
for a brain tumor at the neurosurgery or pediatric oncology departments between 2015 and 2022, were included. Various cadres
(consultants, residents, medical officers, clinical officers, nurses, counselors) and teams (neurosurgery, pediatric oncology, radio-
oncology, radiology, pathology) involved in pediatric brain tumor care participated.
Results: Seventy-nine brain tumor patients were identified. The most prevalent confirmed diagnosis was medulloblastoma (n
= 21). Most patients underwent surgery (n = 60; 76%). Event-free survival rate at 2 years was 13%. Abandonment was the most
common (n = 36; 46%) treatment failure. Multidisciplinary consultation occurred more frequently between 2020 and 2022 than
between 2015 and 2019 (OR 2.7 [95% CI: 1.0–6.9; p = 0.04]). Barriers and potential facilitators of multidisciplinary management were
resources, diagnostic and therapeutic flow, standards, knowledge, information comprehension, and work relationships. Themes
interacted at a governmental, facility, and community level.
Conclusion: This baseline overview of pediatric neuro-oncology care in Western Kenya showed that survival of children with
pediatric brain tumors was poor and treatment abandonment was common. Strengthening the capacity at different organizational
levels will improve continuity of care and expand the knowledge to support holistic multidisciplinary care for children with brain
tumors in Kenya.