Childhood deaths from malignant neoplasms in Accra

Abstract

Background: Malignant neoplasms are set to become a leading cause of childhood death in sub- Saharan Africa as immunization programmes reduce deaths due to infectious diseases. Knowledge of the pattern of deaths from these neoplasms is therefore desirable. Objective: To describe the pattern of deaths from paediatric malignancies, compare this to morbidity figures and provide baseline data for planning child care services. Methods: A 10 year retrospective survey of autopsy cases of paediatric malignancies at the Korle-Bu Teaching Hospital Mortuary was carried out based on autopsy files form January 1, 1990 to December 31, 1999 Results: A total of 252 cases of childhood malignant tumours were retrieved, 139 males and 113 females with a male to female ratio of 1.2:1. The most common malignancy was lymphoma forming 54% of cases and almost all of Non-Hodgkin’s type. Non-Burkitts type (29%) was the commonest followed by Burkitts (24%) and Hodgkin’s disease only one percent. The lymphomas were followed by central nervous system (CNS) tumours (13%), nephroblastomas(10.3%) leukemias (6.7%) hepatic tumours (4%) and sarcomas (2.6%). Less common tumours were Neuroblastomas (2.4%) and retinoblastomas (2%). Conclusion: Overall the pattern of deaths from paediatric malignancies followed the pattern of relative incidence in morbidity figures from Ghana and the subregion except for a relatively higher proportion of deaths from CNS tumours and a lower proportion from sarcomas. The pattern of cancer deaths seen in this study is similar to that seen in advanced countries except that lymphomas replace leukemia as the commonest cause of death