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

PMTCT Programme reduced vertical transmission of HIV in Abuja, Nigeria

Objective: To determine the rate of mother to child transmission of HIV following the introduction of PMTCT program in Abuja.Method: A prospective study of 355 seropositive mothers and their newborns was conducted at the National Hospital Abuja and Asokoro District Hospital Abuja over a 12 months’ period following ethical approval. Using DNA PCR the HIV status of all the exposed babies delivered over the period was determined by taking their peripheral blood at 6 weeks of age. This was repeated 6 weeks post cessation of breast feeding for breastfed babies.. Furthermore, the babies were categorized based on the extent of participation of their mothers in the PMTCT programme and the transmission rates obtained were compared.Result: An overall HIV vertical transmission rate of 6.4% (23/359) was found. A lower rate of 1.6% (5/311) was obtained for those whose mothers fully accessed PMTCT programme as opposed to 15.0% (3/20) for those whose mothers had incomplete participation and 53.6%(15/28) for those whose mothers did not participate.Conclusion: Full participation in PMTCT programme significantly reduced mother to child transmission of HIV.Keywords: Paediatric HIV/ AIDS, MTCT, PMTCT, DNA-PCR, Abuja, Nigeri