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La Mascota Pediatric Hemato-oncology Program for the treatment of Childhood Cancer in Nicaragua Dr. Roberta Ortiz, MD Pediatric Hemato-oncology Department La Mascota Children’s Hospital Managua, Nicaragua
Nicaragua ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],UNICEF 2003 ∕  CEPAL 2001/Pediatric Oncology Department Data Base
La Mascota Program Historical Aspects ,[object Object],[object Object]
Rationale ,[object Object],G. Masera, F. Cavalli, F. Baez et al. North-South twinning  in paediatric haematologyoncology: La Mascota Programme, Nicaragua Lancet 1998;352:1923-1926
Aims of the Program ,[object Object],[object Object],[object Object]
Challenges faced ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Infrastructure ,[object Object],[object Object],[object Object]
Physical Structure  
Results Achieved F . Baez, F. Fossati Bellani, F. Cavalli et al.  Treatment of Childhood Wilms’ Tumor without Radiotherapy in Nicaragua .  Ann Oncol 2002. 13: 944-948 F. Baez, E. Ocampo, V. Conter et al.  Treatment of Childhood Hodgkin’s Disease with COPP or COPP-ABV (hybrid) without  Radiotherapy in Nicaragua .  Ann Oncol 1997.8: 247-250 Pediatr Blood Cancer, 43(4):348, 2004 Increasing number of cases. POND-La Mascota Data Base
Economic Sources to Achieve Continuity  ,[object Object],[object Object],[object Object],[object Object],[object Object]
International Sources ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Still Problems to overcome Abandoment or Lost to therapy (%) 88 90 92 96 25 50 0 %  35 23 14 6 Psychosocial- Support Program  Psychologist Social Worker  “ Support a Child” Program  Residence for families ALL- Managua-protocols 2000 10 MITCH 94 99 20 14 02 8 04 7
Abandonment - Disease La Mascota-POND Data Base 7.7 % Wilms’ Tumor 18.6 % Hodgkin Lymphoma 17.6 % Burkitt Lymphoma 11.6 % Acute Leukemias Abandonment of Therapy (%) Type of cancer
Abandonment=Social Problem ,[object Object],[object Object],[object Object],[object Object],[object Object],Analyses of causes of abandonment in ALL Managua 2000 Protocol 16.1 % 14 74 > 6 11.5 % 10 87 4 - 6 4.8 % 8 167 1 - 3 3.8 % 1 26 0 % # Lost to Therapy # Pts Hrs  from Managua.
Actions to reduce abandonment  of therapy ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Delayed Diagnoses ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Silva Y, Monographic Thesis 2005
Adressing The Problem ,[object Object],[object Object],[object Object],[object Object]
Impact of Educational Campaigns Arguello-Salinas. 1995/Silva . 2003 Monographic Thesis 62% 70% Rabdomiosarcoma 18% 62% Retinoblastoma 60% 87% Wilms’ Tumor 48% 86% NHL 33% 62% HD Stage III-IV After 2002 (%) Stage III-IV Before 2000 (%) Type of  Pediatric Cancer
Current Approaches ,[object Object],[object Object]
Activities Carried Out ,[object Object],[object Object]
Satellite Clinics ,[object Object],[object Object]
Future Activities ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Conclusions ,[object Object],[object Object],[object Object]

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La mascota program presentation for pogo

  • 1. La Mascota Pediatric Hemato-oncology Program for the treatment of Childhood Cancer in Nicaragua Dr. Roberta Ortiz, MD Pediatric Hemato-oncology Department La Mascota Children’s Hospital Managua, Nicaragua
  • 2.
  • 3.
  • 4.
  • 5.
  • 6.
  • 7.
  • 9. Results Achieved F . Baez, F. Fossati Bellani, F. Cavalli et al. Treatment of Childhood Wilms’ Tumor without Radiotherapy in Nicaragua . Ann Oncol 2002. 13: 944-948 F. Baez, E. Ocampo, V. Conter et al. Treatment of Childhood Hodgkin’s Disease with COPP or COPP-ABV (hybrid) without Radiotherapy in Nicaragua . Ann Oncol 1997.8: 247-250 Pediatr Blood Cancer, 43(4):348, 2004 Increasing number of cases. POND-La Mascota Data Base
  • 10.
  • 11.
  • 12. Still Problems to overcome Abandoment or Lost to therapy (%) 88 90 92 96 25 50 0 % 35 23 14 6 Psychosocial- Support Program Psychologist Social Worker “ Support a Child” Program Residence for families ALL- Managua-protocols 2000 10 MITCH 94 99 20 14 02 8 04 7
  • 13. Abandonment - Disease La Mascota-POND Data Base 7.7 % Wilms’ Tumor 18.6 % Hodgkin Lymphoma 17.6 % Burkitt Lymphoma 11.6 % Acute Leukemias Abandonment of Therapy (%) Type of cancer
  • 14.
  • 15.
  • 16.
  • 17.
  • 18. Impact of Educational Campaigns Arguello-Salinas. 1995/Silva . 2003 Monographic Thesis 62% 70% Rabdomiosarcoma 18% 62% Retinoblastoma 60% 87% Wilms’ Tumor 48% 86% NHL 33% 62% HD Stage III-IV After 2002 (%) Stage III-IV Before 2000 (%) Type of Pediatric Cancer
  • 19.
  • 20.
  • 21.
  • 22.
  • 23.