Twelve-month observational study of children with cancer in 41 countries during the COVID-19 pandemic

Introduction Childhood cancer is a leading cause of death. It is unclear whether the COVID-19 pandemic has impacted childhood cancer mortality. In this study, we aimed to establish all-cause mortality rates for childhood cancers during the COVID-19 pandemic and determine the factors associated with mortality. Methods Prospective cohort study in 109 institutions in 41 countries. Inclusion criteria: children <18 years who were newly diagnosed with or undergoing active treatment for acute lymphoblastic leukaemia, non-Hodgkin's lymphoma, Hodgkin lymphoma, retinoblastoma, Wilms tumour, glioma, osteosarcoma, Ewing sarcoma, rhabdomyosarcoma, medulloblastoma and neuroblastoma. Of 2327 cases, 2118 patients were included in the study. The primary outcome measure was all-cause mortality at 30 days, 90 days and 12 months. Results All-cause mortality was 3.4% (n=71/2084) at 30-day follow-up, 5.7% (n=113/1969) at 90-day follow-up and 13.0% (n=206/1581) at 12-month follow-up. The median time from diagnosis to multidisciplinary team (MDT) plan was longest in low-income countries (7 days, IQR 3-11). Multivariable analysis revealed several factors associated with 12-month mortality, including low-income (OR 6.99 (95% CI 2.49 to 19.68); p<0.001), lower middle income (OR 3.32 (95% CI 1.96 to 5.61); p<0.001) and upper middle income (OR 3.49 (95% CI 2.02 to 6.03); p<0.001) country status and chemotherapy (OR 0.55 (95% CI 0.36 to 0.86); p=0.008) and immunotherapy (OR 0.27 (95% CI 0.08 to 0.91); p=0.035) within 30 days from MDT plan. Multivariable analysis revealed laboratory-confirmed SARS-CoV-2 infection (OR 5.33 (95% CI 1.19 to 23.84); p=0.029) was associated with 30-day mortality. Conclusions Children with cancer are more likely to die within 30 days if infected with SARS-CoV-2. However, timely treatment reduced odds of death. This report provides crucial information to balance the benefits of providing anticancer therapy against the risks of SARS-CoV-2 infection in children with cancer

Child Electronic Growth Monitoring System: An innovative and sustainable approach for establishing the Kaduna Infant Development (KID) Study in Nigeria

Background:Developing countries bear the burden of childhood stunting but lack resources for cohort studies to develop preventive strategies. To enable future prospective studies, we designed and tested the Child Electronic Growth Monitoring System (CEGROMS) using a readily available electronic data capture platform, the Research Electronic Data Capture (REDCap). Objectives:To demonstrate the feasibility of using CEGROMS for data collection for a pilot study for the Kaduna Infant Development (KID) Birth Cohort Study in Nigeria. Methods:CEGROMS consists of the data capture form for growth monitoring, a central cloud server, electronic tablets, and desktop computer. We implemented the pilot study in 2017-2019 at the Barau Dikko Teaching Hospital, Kaduna, Nigeria. Odds ratios (OR) and 95% confidence intervals (CI) were calculated for completeness of baseline data (relative to individuals with incomplete data) and completion of follow-up at different time points (relative to individuals with no follow-up visit) by the participant characteristics. Complete data were defined as date of birth, sex, and birthweight recorded at recruitment. Results:Among 3152 infant records in CEGROMS, 2789 (88.5%) had complete data. Of these, 1905 (68.3%) had at least one follow-up visit. The main determinants of data completeness were health facility delivery (OR 19.17, 95% CI 13.65, 26.92) and tertiary education (OR 3.54, 95% CI 2.69, 4.67). Follow-up was greater for women with tertiary education (OR 1.33, 95% CI 1.06, 1.51 for at least one visit). Maternal education is associated with completeness and follow-up (following adjustments for parity and employment). Conclusions: The CEGROMS electronic data collection system enables complete and consistent data collection. The data will enable design of strategies to improve follow-up in the future implementation of the birth cohort study.MK and SJL are supported by the Intramural Research Program of the National Institutes of Health (NIH), National Institute of Environmental Health Sciences, ZO1 ES-49019. Epidemiological Resources and Investigation Consultancy Limited and Perinatal Epidemiological Research Unit, Kaduna (Nigeria), provided infrastructure and human resource for data collection and management

Sefficiency of a water use system: the case of Kano River irrigation project, Nigeria

Northern Nigeria is part of the semi-arid region of Africa experiencing water scarcity. The ever increasing population and climate change have placed a considerable pressure on Kano River Irrigation Project (KRIP), a major water user on Kano River, the most upstream tributary of Yobe River flowing directly to Lake Chad which is an important transboundary basin in West Africa. Performance of KRIP was evaluated using meso-level of the new and innovative Sefficiency (sustainable efficiency) framework, which incorporates quantity, quality, and beneficial aspects of water use in a comprehensive and systemic manner. Two major stakeholders were contacted, namely, farmers and water managers, and their views on the value of water flows were registered through interviews. The results indicated that useful consumption relative to effective consumption of farmers is significantly lower than management, showing a higher relative consumptive impact on both KRIP and Kano River. In addition, the useful outflow per unit of useful inflow is lower according to the farmers relative to the managers. Water managers underscore the importance of pollution impacts, give relevance in allocating water to downstream users including environmental flows, and contributing to groundwater recharge, whereas farmers do not. Flawed classical efficiency in use globally gives much lower values than mesoefficiency. For proper policy analysis in KRIP, the paper recommends using meso-efficiency with technologies to derive better data and to educate farmers on the importance of pollution and return flow.This work is partially financed by the Portuguese Foundation for Science and Technology (FCT) under the contract UID/ECI/04047/2013 for the Centre of Territory, Environment and Construction (CTAC). The support provided by the management of Hadejia-Jama’are River Basin Development Authority (H-JRBDA) and farmers in Kano River Irrigation Project (KRIP) especially Abdulkadir Abdulmalik and those that participated in the survey are duly acknowledged. Moreover, the authors thank the anonymous reviewers for their helpful comments.info:eu-repo/semantics/publishedVersio