South African Journal of Child Health
On-line version ISSN 1999-7671
Print version ISSN 1994-3032
STEFAN, D C; STONES, D K; VAN ZYL, A and UYS, R. The cost of nephroblastoma treatment in South Africa: A very cost-effective investment with guidelines for the rest of Africa. S. Afr. j. child health [online]. 2014, vol.8, n.4, pp.128-132. ISSN 1999-7671. http://dx.doi.org/10.7196/SAJCH.749.
BACKGROUND: Nephroblastoma is one of the most common childhood malignancies in Africa, but with a survival rate significantly lower than in developed countries. In African countries with a small gross domestic product (GDP) per capita, the cost of treating nephroblastoma may be prohibitive. OBJECTIVES: To determine the direct costs of treatment of nephroblastoma in South Africa (SA) and to propose a more cost-effective approach to investigations and treatment for the disease in Africa. METHODS: Data from 2000 to 2010 from two SA paediatric oncology units were retrospectively analysed. The costs included investigations, chemotherapy and radiotherapy, comparing early- v. advanced-stage disease. In both units, the nephroblastoma International Society of Paediatric Oncology (SIOP) protocol was used. RESULTS: Stage I disease was the most common, followed by stage IV. The total cost of diagnosis, staging and treatment of stage I disease was ZAR9 304.97 (EUR882.80 or USD1 093.40), compared with a five-times higher cost for stage IV (ZAR48 293.62 (EUR4 581.9 or USD5 674.9)). Treating one patient averted more than 32 disability-adjusted life years. The investigation and treatment of early- and advanced-stage disease is very cost-effective when compared with the local GDP per capita. CONCLUSION: The cost of investigation and treatment of nephroblastoma remains a challenge everywhere, but especially in Africa. However, it is a very cost-effective disease to treat and children in Africa should not be denied treatment.