The implementation of a national paediatric oncology protocol for neuroblastoma in South Africa

Jaques van Heerden^{1

2}, Marc Hendricks^{3

4}, Janet Poole⁵, Ané Büchner⁶, Gita Naidu⁷, Jan du Plessis⁸, Barry van Emmenes⁹, Anel van Zyl¹⁰, Ronelle Uys¹⁰, Johani Johani¹¹, G P Hadley¹², Derek Harrison¹³, Biance Rowe⁷, Mairi Bassingthwaighte⁷, Nicolene Moonsamy¹⁴, Mariana Kruger¹⁰; SACCSG Neuroblastoma Workgroup

Affiliations

¹ Paediatric Haematology and Oncology, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg Hospital, Cape Town, South Africa. Jaques.vanheerden@uza.be.
² Paediatric Haematology and Oncology, Department of Paediatrics, Antwerp University Hospital, Drie Eikenstraat 655, 2650, Edegem, Antwerp, Belgium. Jaques.vanheerden@uza.be.
³ Department of Paediatrics and Child Health, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.
⁴ Paediatric Haematology and Oncology Service, Red Cross War Memorial Children's Hospital, Cape Town, South Africa.
⁵ Faculty of Health Sciences, Division of Paediatric Haematology and Oncology, Department of Paediatrics and Child Health, University of the Witwatersrand, Charlotte Maxeke Johannesburg Academic Hospital, Johannesburg, South Africa.
⁶ Paediatric Haematology and Oncology, Department of Paediatrics, University of Pretoria, Steve Biko Academic Hospital, Pretoria, South Africa.
⁷ Faculty of Health Sciences, Division of Paediatric Haematology and Oncology, Department of Paediatrics and Child Health, University of the Witwatersrand, Chris Hani Baragwanath Academic Hospital, Johannesburg, South Africa.
⁸ Division of Paediatric Haematology and Oncology, Department of Paediatrics, Faculty of Health Sciences, Universitas Hospital, University of the Free State, Bloemfontein, South Africa.
⁹ Division of Paediatric Haematology and Oncology Hospital, Department of Paediatrics, Frere Hospital, East London, South Africa.
¹⁰ Paediatric Haematology and Oncology, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg Hospital, Cape Town, South Africa.
¹¹ Paediatric Haematology Oncology, Department of Paediatrics and Child Health, Port Elizabeth Provincial Hospital, Walter Sisulu University, Port Elizabeth, South Africa.
¹² Department of Paediatric Surgery, Faculty of Health Sciences, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa.
¹³ Faculty of Health Sciences, Department of Paediatric Surgery, University of the Witwatersrand, Chris Hani Baragwanath Academic Hospital, Johannesburg, South Africa.
¹⁴ Department of Paediatric Haematology and Oncology, Faculty of Health Sciences, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Inkosi Albert Luthuli Academic Hospital, Durban, South Africa.

PMID: 33881651
PMCID: PMC8058747
DOI: 10.1007/s10552-021-01424-2

The implementation of a national paediatric oncology protocol for neuroblastoma in South Africa

Jaques van Heerden et al. Cancer Causes Control. 2021 Jul.

. 2021 Jul;32(7):725-737.

doi: 10.1007/s10552-021-01424-2. Epub 2021 Apr 21.

Authors

Affiliations

¹ Paediatric Haematology and Oncology, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg Hospital, Cape Town, South Africa. Jaques.vanheerden@uza.be.
² Paediatric Haematology and Oncology, Department of Paediatrics, Antwerp University Hospital, Drie Eikenstraat 655, 2650, Edegem, Antwerp, Belgium. Jaques.vanheerden@uza.be.
³ Department of Paediatrics and Child Health, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.
⁴ Paediatric Haematology and Oncology Service, Red Cross War Memorial Children's Hospital, Cape Town, South Africa.
⁵ Faculty of Health Sciences, Division of Paediatric Haematology and Oncology, Department of Paediatrics and Child Health, University of the Witwatersrand, Charlotte Maxeke Johannesburg Academic Hospital, Johannesburg, South Africa.
⁶ Paediatric Haematology and Oncology, Department of Paediatrics, University of Pretoria, Steve Biko Academic Hospital, Pretoria, South Africa.
⁷ Faculty of Health Sciences, Division of Paediatric Haematology and Oncology, Department of Paediatrics and Child Health, University of the Witwatersrand, Chris Hani Baragwanath Academic Hospital, Johannesburg, South Africa.
⁸ Division of Paediatric Haematology and Oncology, Department of Paediatrics, Faculty of Health Sciences, Universitas Hospital, University of the Free State, Bloemfontein, South Africa.
⁹ Division of Paediatric Haematology and Oncology Hospital, Department of Paediatrics, Frere Hospital, East London, South Africa.
¹⁰ Paediatric Haematology and Oncology, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg Hospital, Cape Town, South Africa.
¹¹ Paediatric Haematology Oncology, Department of Paediatrics and Child Health, Port Elizabeth Provincial Hospital, Walter Sisulu University, Port Elizabeth, South Africa.
¹² Department of Paediatric Surgery, Faculty of Health Sciences, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa.
¹³ Faculty of Health Sciences, Department of Paediatric Surgery, University of the Witwatersrand, Chris Hani Baragwanath Academic Hospital, Johannesburg, South Africa.
¹⁴ Department of Paediatric Haematology and Oncology, Faculty of Health Sciences, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Inkosi Albert Luthuli Academic Hospital, Durban, South Africa.

PMID: 33881651
PMCID: PMC8058747
DOI: 10.1007/s10552-021-01424-2

Abstract

Purpose: The aim of the World Health Organization-International Paediatric Oncology Society is to improve childhood cancer survival in low- and middle-income countries to 60% by 2030. This can be achieved using standardised evidence-based national treatment protocols for common childhood cancers. The aim of the study was to describe the development and implementation of the SACCSG NB-2017 neuroblastoma (NB) treatment protocol as part of the treatment harmonisation process of the South African Children's Cancer Study Group.

Methods: The Consolidated Framework for Implementation Research was used to identify factors that could influence the implementation of the national NB protocol as a health care intervention. The evaluation was done according to five interactive domains for implementation: intervention characteristics, inner setting, outer setting, individual or team characteristics and the implementation process.

Results: The protocol was developed over 26 months by 26 physicians involved in childhood cancer management. The process included an organisational phase, a resource identification phase, a development phase and a research ethics approval phase. Challenges included nationalised inertia, variable research ethical approval procedures with delays and uncoordinated clinical trial implementation.

Conclusion: The implementation of the national NB protocol demonstrated the complexity of the implementation of a national childhood cancer treatment protocol. However, standardised paediatric cancer treatment protocols based on local expertise and resources in limited settings are feasible.

Keywords: Children; Consolidated Framework for Implementation Research; National protocols; Neuroblastoma; South Africa.

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Conflict of interest statement

The author(s) declare that they have no financial or personal relationship(s) that may have inappropriately influenced them in writing this article.

Figures

**Fig. 1**
The protocol and guidelines development process

See this image and copyright information in PMC

References

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The implementation of a national paediatric oncology protocol for neuroblastoma in South Africa

Affiliations

The implementation of a national paediatric oncology protocol for neuroblastoma in South Africa

Authors

Affiliations

Abstract

Conflict of interest statement

Figures

References

MeSH terms

LinkOut - more resources

Full Text Sources

Other Literature Sources

Medical