JMIR Publications

ABSTRACT

Background:

Childhood cancer has an annual incidence of 150-160 cases per million children worldwide but remains vastly under-diagnosed in low to middle income countries (LMIC) such as in Sub-Saharan Africa. Moi Teaching and Referral Hospital (MTRH) serves a population of 25 million people, including 10 million children. The average number of pediatric cancer diagnoses was 216 cases annually in 2017-2019, well below the anticipated 1500 cases based on epidemiology data.

Objective:

To address disparities in medical knowledge leading to low diagnostic cancer rates in children, we implemented Project ECHO – a validated virtual guided practice and telementoring model – to connect multidisciplinary specialists at MTRH with staff in medically underserved communities in western Kenya for training, technical assistance, and mentorship.

Methods:

Sessions were freely available on Zoom twice monthly and featured an expert-led didactic topic and a learner-led case-based discussion. The discussion utilized dialogue education to promote learning and engagement among participants with mentorship from the expert team. Information on ECHO participation was tracked while the program ran in parallel with the pediatric oncology cancer registry.

Results:

The ECHO program launched successfully in January 2020 with a curriculum focused on pediatric oncology for healthcare providers. A total of 22 sessions occurred with an average of 23 learners per session. The year-end analysis in January 2021 demonstrated 286 new pediatric patients were diagnosed with cancer at MTRH representing a 33% increase over the 3-year average.

Conclusions:

The Project ECHO platform created a dynamic virtual platform to continue to engage stakeholders across Western Kenya. The implementation of this telehealth education platform in Kenya, represents an effective model to increase the recognition and earlier referral of childhood cancer in LMICs.