National Institute for Medical Research - Mwanza Centre, Mwanza, Tanzania.
National Institute for Medical Research - Muhimbili Centre, Muhimbili, Tanzania.
Pediatr Blood Cancer. 2024 Nov;71(11):e31278. doi: 10.1002/pbc.31278. Epub 2024 Sep 5.
Timely diagnosis of childhood cancer, early hospital presentation and completion of treatment significantly improve outcomes. Unfortunately, in Tanzania, thousands of children die of cancer each year without ever being diagnosed or treated. To reduce childhood death from cancer, it is important to understand the social-cultural context, values and beliefs that influence healthcare-seeking behaviours among the Tanzanian community.
This was a cross-sectional qualitative study conducted in Mwanza, Kilimanjaro and Dar-es-Salaam regions between March and June 2021. We purposively selected community members aged ≥18 years from three rural and three urban settings to participate in seven focus group discussions (each with eight to 12 respondents). The participants were from communities without any affiliation to the treatment of children with cancer or treatment facilities. We transcribed, coded and analyzed data using a thematic-content approach with the support of NVIVO 12 software.
Many had heard of breast or cervical cancer; however, most were unaware of childhood cancer. Adults believe that cancer in children is caused by witchcraft and cannot be cured by modern medicines available at hospitals. These beliefs lead parents to first seek care from traditional healers, which hence delay presentation to the hospital. Other community concerns included the cost of transportation, investigation-related costs, and the long duration of treatment. These have an influence on treatment adherence leading to seeking alternative treatment, such as spiritual or traditional treatment.
Low community awareness, late hospital presentation, and treatment abandonment remain a challenge in childhood cancer in most parts of Tanzania. Belief about childhood cancer being a result of witchcraft and superstition contributes to limited health-seeking behaviours. Cultural and contextually relevant awareness campaign interventions are needed to increase cancer knowledge in Tanzanian communities.
及时诊断儿童癌症、尽早到医院就诊并完成治疗可以显著改善预后。然而，在坦桑尼亚，每年仍有成千上万的儿童死于癌症，甚至从未得到诊断或治疗。为了降低儿童癌症死亡率，了解影响坦桑尼亚社区寻求医疗服务行为的社会文化背景、价值观和信念非常重要。
这是一项 2021 年 3 月至 6 月在姆万扎、乞力马扎罗和达累斯萨拉姆地区进行的横断面定性研究。我们从三个农村和三个城市地区有目的地选择了≥18 岁的社区成员参加七个焦点小组讨论（每个讨论组有 8 到 12 名参与者）。参与者来自与治疗儿童癌症或治疗设施没有任何关联的社区。我们使用 NVIVO 12 软件支持的主题内容方法进行转录、编码和分析数据。
许多人听说过乳腺癌或宫颈癌；然而，大多数人不知道儿童癌症。成年人认为儿童癌症是由巫术引起的，无法用医院提供的现代药物治愈。这些信念导致父母首先寻求传统治疗师的治疗，从而延误了到医院就诊的时间。社区的其他关注点包括交通费用、检查相关费用和治疗的漫长时间。这些因素会影响治疗依从性，导致寻求替代治疗，如精神或传统治疗。
在坦桑尼亚大部分地区，社区意识低、就诊晚和治疗中断仍然是儿童癌症治疗面临的挑战。认为儿童癌症是巫术和迷信的结果的信念导致了有限的健康寻求行为。需要开展具有文化和背景相关性的宣传活动，以提高坦桑尼亚社区对癌症的认识。
