title: Abandonment of childhood cancer treatment in Western Kenya.
abstract: BACKGROUND
  The most important reason for childhood cancer treatment failure in low-income countries is treatment abandonment.
  
  
  OBJECTIVE
  The aim of this study was to explore reasons for childhood cancer treatment abandonment and assess the clinical condition of these children.
  
  
  METHODS
  This was a descriptive study using semistructured questionnaires. Home visits were conducted to interview families of childhood cancer patients, diagnosed between January 2007 and January 2009, who had abandoned treatment at the Moi Teaching and Referral Hospital (MTRH).
  
  
  RESULTS
  Between January 2007 and January 2009, 222 children were newly diagnosed with a malignancy at MTRH. Treatment outcome was documented in 180 patients. Of these 180 patients, 98 (54%) children abandoned treatment. From December 2011 until August 2012, 53 (54%) of the 98 families were contacted. Due to lack of contact information, 45 families were untraceable. From 53 contacted families, 46 (87%) families agreed to be interviewed. Reasons for abandonment were reported by 26 families, and they were diverse. Most common reasons were financial difficulties (46%), inadequate access to health insurance (27%) and transportation difficulties (23%). Most patients (72%) abandoned treatment after the first 3 months had been completed. Of the 46 children who abandoned treatment, 9 (20%) were still alive: 6 (67%) of these children looked healthy and 3 (33%) ill. The remaining 37 (80%) children had passed away.
  
  
  CONCLUSIONS
  Prevention of childhood cancer treatment abandonment requires improved access to health insurance, financial or transportation support, proper parental education, psychosocial guidance and ameliorated communication skills of healthcare providers.
authors.forename: F
authors.initials: F
authors.lastname: Njuguna
authors.forename: S
authors.initials: S
authors.lastname: Mostert
authors.forename: A
authors.initials: A
authors.lastname: Slot
authors.forename: S
authors.initials: S
authors.lastname: Langat
authors.forename: J
authors.initials: J
authors.lastname: Skiles
authors.forename: M N
authors.initials: MN
authors.lastname: Sitaresmi
authors.forename: P M
authors.initials: PM
authors.lastname: van de Ven
authors.forename: J
authors.initials: J
authors.lastname: Musimbi
authors.forename: H
authors.initials: H
authors.lastname: Muliro
authors.forename: R C
authors.initials: RC
authors.lastname: Vreeman
authors.forename: G J L
authors.initials: GJ
authors.lastname: Kaspers
mesh_terms: D000293:Adolescent; D002648:Child; D002662:Child Health Services / Q000191:economics*; D002675:Child, Preschool; D005260:Female; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006801:Humans; D007630:Kenya; D008297:Male; D009369:Neoplasms / Q000628:therapy*; D010290:Parents / Q000523:psychology*; D010349:Patient Compliance / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires