Paediatric Oncology in Tonga Background on Tonga Tongas population: 103,252 73 live on main island. Proportion 15yo- 38,457 (37.2) Vaiola is the one main hospital for the kingdom We have 120 admissions per month to our paediatric ward
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Presentation Transcript
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Paediatric Oncology in Tonga<br>
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Background on Tonga Tonga’s population: 103,252
73% live on main island.
Proportion <15yo- 38,457 (37.2%)
Vaiola is the one main hospital for the kingdom
We have ~120 admissions per month to our paediatric ward
~2,500 deliveries/year
Infant mortality 11-16/1000 live births<br>
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Paediatric Services in Tonga 1 Paediatrician
3 Registrars
Interns
4 oncology nurses (1 new recruit)
2 trained have left
34 bed paediatric ward
11 bed SCN<br>
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Pic of ward<br>
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Paediatric Oncology In Tonga Disease burden is approx. 5 cases annually or 140 per million population < 14years old.
Cancers considered for treatment in Tonga Leukemias- only ALL
Lymphomas- most considered, except Hodgkins advanced stage1V and some NHL.
Wilms
Retinoblastoma
Neuroblastomas considered except stage 3 and 4
Germ Cell tumours
*Brain Tumours, soft tissue and bone sarcomas are generally not considered for referral for treatment unless surgically resectable.<br>
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Current Oncology practice We follow the PI ALL-2 protocol.
We carry out the Interim maintenance phase, delayed intensification, and continuous maintenance phase in Tonga now.*
We also do the last 4 months of the Hodgkins treatment protocol and have experience in giving the last month of Retinoblastoma treatment.
We get excellent support from Dr Jane Skeen and the team from Starship Hospital.<br>
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Paediatric Oncology in Tonga Survival rates of cases referred for treatment so far looks favourable.
Overall mortality is high, largely resource issue.
Our team has limited experience with providing chemotherapy locally but we’re making good progress with the support from Starship Hospital, NZ.<br>
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Challenges Biggest challenge is awareness and early presentation of cases.
Dealing with those who do not fit referral criteria, in terms of accepting diagnosis and palliative care.
Central line maintenance (portacaths, PICC lines)
Occasionally have delay in confirmation of diagnosis from lab, but good collaboration via Starship Oncology and Labplus.<br>
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Way forward: Need regular training and support from Starship Oncology team.
Review existing guidelines whether more malignancies can be added to our referral guidelines.
Also more treatment could be delivered locally as we grow the local capability to do so.
