Caregiver Baseline Knowledge, Attitudes, Practices, and Key Knowledge Gaps in Pediatric Cancer Care in Mwanza, Tanzania

Abstract

Pediatric cancer survival rates vary drastically between high-income (HICs) and low-and-middle-income countries (LMICs). While survival rates are nearly 80% in HICs, they drop as low as 15-45% in LMICs, where nearly 90% of children with cancer reside. 1,2 The primary driver of this disparity is treatment abandonment, with nearly half of children in LMICs failing to start or complete therapy. In Tanzania, key barriers to treatment adherence (TA) include low caregiver knowledge, attitudes toward treatment, and a lack of confidence in completing therapy. This study quantifies baseline caregiver knowledge, attitudes, and practices (KAP) while identifying key knowledge gaps and preferred educational strategies for future interventions to improve TA. A mixed-method, cross-sectional survey was conducted at Bugando Medical Center and its associated hostel in Mwanza, Tanzania, using convenience sampling of caregivers whose children were diagnosed within the past year. Results showed low baseline cancer knowledge, particularly regarding diagnosis and supportive care, despite an overwhelmingly positive attitude toward care. Moderate adherence to recommended practices was observed, with higher KAP scores correlating with education level, age, and time since diagnosis. These findings emphasize the urgent need for structured, culturally tailored caregiver education to address misinformation, improve understanding of diagnosis and treatment, and enhance adherence. This study provides a foundation for developing targeted educational interventions, ensuring content aligns with caregiver needs and expectations. Accordingly, the culturally specific KAP survey offers a valuable tool for assessing the effectiveness of future interventions in Tanzania and other low-income settings.