Delay in treatment for childhood acute lymphoblastic leukemia at the University of Gondar Comprehensive Specialized Hospital, Northwestern Ethiopia

Abstract

Background: Despite the critical importance of early blood cancer diagnosis in children for timely treatment, late presentation, delayed diagnosis, and delayed treatment initiation remain significant issues in developing countries, including Ethiopia. Addressing these delays requires improving healthcare infrastructure, public awareness, provider training, and reducing financial barriers. This study aimed to assess referral delays, diagnostic delays, and overall treatment delays among children with acute lymphoblastic leukemia at the University of Gondar Comprehensive Specialized Hospital.

Methods: A facility-based cross-sectional study was conducted among pediatric acute lymphoblastic leukemia (ALL) patients under 18 years. Data were collected using a structured questionnaire administered to primary caregivers from December 29, 2022, to January 30, 2024. During the study, 90 ALL cases were included using a consecutive sampling technique. Data were entered and analyzed using SPSS version 25 software, with results presented through descriptive statistics, including frequencies, percentages, graphs, and tables. Binary logistic regression examined associations between sociodemographic factors and treatment delays among childhood ALL patients.

Results: A total of 90 children participated, 63 (70.0%) male. Median time from first symptoms to medical consultation was 9.7 days, referral delay 51.3 days, diagnosis delay 3.2 days, and treatment initiation delay 4.6 days. Total delay to treatment was 69 days, with induction mortality at 22%. High-risk ALL, malaria, and delays of 30–90 days increased induction mortality risk.

Conclusion: The study revealed significant delays in childhood ALL treatment, contributing to high mortality rates. Timely diagnosis and treatment initiation are critical, particularly for high-risk patients and those with malaria. Strengthening healthcare infrastructure, awareness, and provider training is vital to improve outcomes.