Patterns and treatment outcomes of primary bone tumors in children treated at tertiary referral hospital, Ethiopia.

BACKGROUND: Bone tumors account for approximately 6% of all cancers in children. Malignant bone tumors, commonly occurring in children and adolescents, are associated with high mortality and morbidity. The overall survival of children with primary malignant bone tumors is affected by the stage of disease, time of diagnosis, and treatment response. Despite advanced treatment modalities with chemotherapy, surgery, and radiotherapy, bone tumor is the third leading cause of death in children with malignancy. Patients with metastatic disease at diagnosis have poor outcomes compared to localized disease at presentation. The 5-year Overall Survival and event-free survival in children with primary malignant bone tumors were 85.2% and 69.2%. The study aimed to assess the clinicopathological profile and treatment outcomes of children with primary malignant bone tumors in our setup. MATERIALS AND METHODS: A hospital-based cross-sectional study was conducted on 95 children who met the inclusion criteria through structured questionnaire. The collected data were analyzed using a statistical package for social sciences (SPSS) version 25. P-value < 0.05 was considered to be statistically significant. Kaplan Meier survival estimate was used for overall and event-free survival analysis. RESULTS: A total of ninety-five patients met the study inclusion criteria and the median age at diagnosis with primary malignant bone tumors was 10 years, with an interquartile range of 8-12 years. The duration of the illness from the onset of symptoms to the oncologic treatment center ranges from three weeks to 2 years with a mean duration of five months. Swelling was the commonest presenting symptom accounting for 95.8% (n = 91). Lower extremity was the commonest primary site of involvement accounting for 55.8% (n = 53) of children with primary malignant bone tumors. Osteosarcoma was the commonest malignant bone tumor constituted 66.3% (n = 63), followed by Ewing sarcoma at 33.7% (n = 32). About 41.2% (n = 39) of children had metastatic disease at presentation and the lung was the commonest site of distant metastasis. The Kaplan Meier survival estimate analysis showed the 1-year and 5-year overall survival probabilities for all pediatric primary malignant bone tumor patients were 65% (95% CI: 0.3-0.56) and 38% (95% CI:0.19-0.47) respectively. The 1-year and 5-year event-free survival probabilities were 55% (95% CI: 0.32-0.73) and 33% (95% CI: 0.10-0.59). The stage of the disease at presentation had a significant association with the outcome (p = 0.023). CONCLUSION: Our study showed the mean duration of the illness from the onset of symptoms to the oncologic treatment center was 5 months ranging from 3 weeks to 2 years. More than one-third of the presented with metastatic disease at presentation. The 1-year and 5-year overall survival (OS) probabilities of children with primary malignant bone tumors were low in our setup compared to other studies.

Health-Related Quality of Life and Its Associated Factors in Children and Adolescents with Type1 Diabetes, Addis Ababa, Ethiopia.

Background. In the clinical management of diabetes, fixing metabolic variables is insufficient, and thus, health-related quality of life assessment is becoming an important indicator of the outcome of the treatment and detector of a problem in children and adolescents with chronic disease. Therefore the main aim of this study was to assess the Quality of life of children with type 1 diabetes in Addis Ababa, Ethiopia. Methods. A cross-sectional study design was included 229 study participants with type 1 diabetics aged between 8 and 18 years in Addis Ababa governmental hospitals. Samples were selected by a systematic sampling method and interviewed face to face. Health-related quality of life was determined by the pediatric quality of life inventory. Multivariable linear regression was done and a significant association was declared at P < .05. Result. The total mean score of health-related quality of life was 78.8 ± 15.6 reported by child and 61 ± 7.9 reported by parents. In this study well-controlled glycemic level (ß = 11.8, 95%CI: 8.7, 14.9), health education on diabetes (ß = 5.92, 95%CI: 2.9, 8.9) and frequency of hospital admission (ß = -2.6, 95%CI: -4.8, -0.42) were clinically predicting factors of health-related quality of life. Conclusion. This study found that there was a somewhat reduction in school and emotional functions of health-related quality of life. The glycemic level, health education of diabetes and frequency of hospital admission was clinically significant factors of health-related quality of life. This study will recommend to the health professional to sustain a health education program on diabetes.