RESUMO
Background: There are over 143 million orphans globally, however, sub-Saharan Africa/Asian regions account for over 80% of the global burden (143 million orphans), Nigeria inclusive with over 10 million orphans. This has caused a crisis of shelter, as more children drift towards institutional care rather than staying in communities that are laden with a high prevalence of poverty (70% in Nigeria). This development is not the best practice in the care of Orphans and vulnerable children (OVC) based on national policy of OVC care which recommends Household rather than institutional care. Since studies have shown that Institutional care has a negative impact on a child, the place of placement is thus crucial to the outcome of vulnerable children (VC) which can easily be assessed by measuring the Quality of life (QOL). The aim of this study is to compare the QOL of VC living in Household against those living in Institutions. Methods: A cross-sectional comparative study involving 202 VC (aged 6-18 years) was conducted. VC were sampled using the multistage sampling technique across two orphanages and three communities located in suburban areas in Jos East, Jos North and Jos South Local Government Area. Outcome Measure: Quality of Life was determined using the WHOQOL BY (brief for youth) tool after validity and reliability test was done. The total score was transformed into a score of 1-100, with higher score implying higher QOL. Data generated were processed and analyzed using the EPI info version 3.5.1 statistical software. A score < -1 standard deviation (SD) from mean was considered poor, ±1 SD to -1 SD was considered fair and > ±1 SD was considered good. The student t-test was used for comparison of means while chi-square test or fisher exact test was used for comparison of categorical variables. In all statistical tests a p values ≤ 0.05 was considered significant. Results: The QOL score for the study population ranged between 47.2 to 95.2, the mean QOL was 75.2±8.1. The median and mode were both equal (QOL score of 75.2). Comparatively, IVC had higher mean QOL score of 76.9±7.0 compared to HVC 73.3±8.9 (p=0.002). IVC had higher scores compared to HVC in the following domain: psychological (p=0.05), social (p=0.004) and environmental (p=0.002). Conclusion: The QOL of VC in Institution is better than children in suburban Households in Jos Nigeria. IVC are better psychosocially and environmentally. However, a Qualitative study is needed for more depth.
RESUMO
The outcome of pediatric cancer therapy in the developed country is good however in Developing countries like Nigeria pediatric cancer treatment is characterized by late presentation, presences of co-morbidities and outright refusal of investigation and initiation or continuation of treatment. This might be because of socio economic reasons. This study set out to determine the proportion of cancer patients who abandoned their therapy and identify the socioeconomic factors associated with AT among children diagnosed with malignancy. Methods: Hospital records of 41 children admitted for childhood malignancy at the Jos University Teaching Hospital over a period of 2 years were retrieved and data was obtained from them regarding their biodata, diagnosis, treatment procedure and outcome. Data was computed using EPI info version 7.0 statistical software. Abandonment of Treatment was compared with socio-economic variables using the chi square test or fisher exact score at 95% confidence interval. A p value of < 0.05 was considered statistically significant. Results: The prevalence of abandoning of treatment was 63.4%. The odds of AT was 4.5 times higher in children who were less than 10 years of age compared to older children. Children from smaller families (4 children or less) had a 3.4 odds of abandoning treatment than large families. The odds of abandoning treatment was 16 times (CI= 1.2-200.5) higher if a mother was the caregivers while the child was on hospital admission compared to others. AT was significantly higher in children who travel for ≥ 2 hours before arrival at the hospital (travelled for more than 2 hrs from their homes for therapy in JUTH). Socio economic status, parental education, gender, marital status of parent and birth order did not have any statistical association with AT. Conclusion: The high rate of AT in pediatric cancer patient in Jos university Teaching Hospital is associated with socioeconomic factors. Further studies with a larger sample size will give more insight into this problem and pave way for possible solutions.