Wilms’ tumour is a relatively common and treatable kidney tumour in children, with survival rates in high income countries of around 85%. However, survival in low income countries is much lower with survival rates of around 10 – 35%. But it is a tumour highly responsive to treatment. The UK-registered charity, World Child Cancer, has been involved in addressing this issue in Malawi, seeing survival rates increase from just over 20% to around 50% over the last 5 years. These possible rates of improvements have inspired the development of the Wilms’ tumour project, which involves an African-led Wilms’ Tumour regional collaborative group that has been formed to apply this comprehensive treatment protocol to African settings. At present, there are 5 participating countries (Malawi, Cameroon, Ghana, Ethiopia and Zimbabwe) and the guidelines will be tested with around 150 new patients a year across these 5 countries.
The Chalker Foundation for Africa is supporting World Child Cancer by investing in the training and development programme across the five countries, taking the learning and success from the work in Malawi. In order to address the specific in-country challenges that the study identified, the emphasis will be on: social support to enable parents to complete treatment and provision of adequate supportive care; the role of ultrasonography in diagnosis; pre-operative chemotherapy with a reduced dosage for malnourished children; and post-operative chemotherapy based on surgical staging. In response, this project will provide the specialised and context-appropriate training needed for local health-care professionals as well as providing subsidies to patients and their families. As a result, the expected outcomes include an increased survival rate to 50%; reduced abandonment below 10% at all sites; and reduced treatment related mortality to less than 10% at all sites.