Factors Influencing Delay to Diagnosis and Treatment among Pediatric Oncology Patients at Tikur Anbessa Specialized Hospital, Addis Ababa Ethiopia: A cross- sectional survey

Background Childhood cancer is becoming the largest cause of disease-related mortality in the world, especially in Ethiopia. Delays in cancer diagnosis and treatment can lead to a poor prognosis and quality of life. Objective This study aimed to assess factors influencing delay to diagnosis and initiation of treatment among pediatric oncology patients attending at Tikur Anbessa specialized hospital oncology unit, in Addis Ababa, Ethiopia, 2019. Methods Between February and April 2019, 244 pediatric cancer patients participated in an institutional-based cross-sectional study. Data were gathered from parents/caregivers via interviews and a structured questionnaire, with medical record reviews supporting the findings. To assess the relationship between dependent and independent factors, bivariate and multivariate analyses with odds ratios (OR) were used. Statistical analysis was performed using STATA (Version 14) with a significance level of P < 0.05. Result A total of 244 children participated, with mean age of 6.4 years (SD ± 3.2). In terms of delay, 127(52.0%) were patient delay (> 30 days) and 104(42.6%) were health system delay. Children aged 5–9 years AOR = 2.98, 95% CI,1.35, 6.57; while children from rural regions had an AOR of 2.28 (95% CI, 1.07–4.88). Furthermore, it was discovered that parents of children who consulted traditional healers (AOR = 7.85, 95% CI = 3.88, 15.89) were more likely to be delayed than their counterparts. Health system-related factors such as not having medical insurance AOR;5.52 95%CI; (2.61,11.69) and first visit to the health facility AOR; 16.13; 95%CI; 4.00,65.03 were determined to be the explanation for delay. Conclusion and Recommendations Patient delay was significantly associated with age, place of residence, child diagnosis, and visits to traditional Hillers (P < 0.05). To reduce patient delays, health education efforts should be designed to raise parental awareness of the early indications of cancer and the need of early presentation at health institutions. As a result, health practitioners should be educated on the symptoms of children cancer, and suspicious clinical aspects should be investigated promptly in order to diagnose the disease early and begin definitive therapy.