Browsing by Author "Maradiegue, E"

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Catalyzing Childhood Cancer Care in Peru After One Year of the Global Initiative for Childhood Cancer
(American Society of Clinical Oncology, 2021) Vasquez, L; Maradiegue, E; Rojas Montoya, J; Zapata, A; Ugaz, C; Pascual, C; Santillán, C; Wachtel, A; Celis, E; Bernedo, H; Rossi, J; Saldaña, L; Diaz, R; Morales, R; Perez, V; Metzger, ML; Luciani, S
Tesis desarrollada en el ámbito de la Ingeniería, orientada al análisis y/o solución de problemáticas técnicas propias de la disciplina.
Fortalecimiento de las políticas de salud pública contra el cáncer infantil: logros de Perú en el marco de la Iniciativa Mundial de la OMS contra el Cáncer Infantil
(Pan American Health Organization, 2023) Maradiegue, E; Pascual, C; Vasquez, L; Maza, I; Ugaz, C; Montoya, J; Zapata, A; García, H; Chavez, S; Ordoñez, K; Rossi, J; Diaz, R; Morales, R; Trigoso, V; Ames, R; Celis, E; Barzola, I; Torres, L; Cosme, M; Tarrillo, F; Rojas, N; Santillan, C; Quispe, Y; Palacios, V; Godoy, V; Tello, M; Tarco, D; Wachtel, A; Malaver, E; Diaz, E; Goyburu, M; Perez, V; Talavera, I; Baca, ME; Maza M; Saldaña, L; Holguin, A; Jarquin, M; Loggetto, P; Metzger, M; Friedrich, P; Lam, C; Rodriguez-Galindo, C
Objective. To report the progress in Peru, since June 2019, in the implementation of the World Health Organization Global Initiative for Childhood Cancer using the CureAll framework, which can be replicated in low- and middle-income countries. Methods. A mixed method was used of participatory and documentary evaluation. The participatory evaluation included stakeholders from various government institutions, nonprofit organizations, and international partners. The documentary aspect consisted of a review of data on the regulatory environment, national projects, and interventions implemented. The Ministry of Health engaged more than 150 participants to form working committees, which have developed policy and regulatory documents to strengthen care services. Results. Achievements include a decrease in the national treatment abandonment rate from 18.6% to 8.5%, the approval of the Childhood Cancer Law, improvements in the management of patients with febrile neutropenia, and a reduction in rates of events of clinical deterioration and mortality of hospitalized patients. The Cure All implementation framework allows local teams to implement specific strategies and monitor early outcomes in pediatric oncology. Conclusions. The results obtained reflect the teamwork, the leadership of the authorities, the technical support of professionals, and the support of involved organizations. Further actions will be needed to guarantee sustainability, and monitoring tools are needed to assure success in the planned activities.
Impact of COVID-19 in pediatric oncology care in Latin America during the first year of the pandemic
(John Wiley and Sons Inc, 2022) Villanueva, G; Sampor, C; Palma, J; Villarroel, M; Valencia, D; Lombardi, MG; Garcia, WG; Caceres, EL; Sobrero, V; Garcia, L; Cabrera, V; Maza, I; Velasquez,T; Ugaz, C; Vasquez, JM; Coronado, RD; Gonzalez, N; Aguiar, S; Dabezies A; Moreno, F; Sardinas, S; Gamboa, Y; Maradiegue, E; Fu, L; Gassant, P; Moreno, K; Gonzales, O; Schelotto, M; Luna-Fineman, S; Antoneli, CG; Fuentes-Alabi, S; Luciani, S; Cappellano, A; Chantada, G; Vasquez, L
Background: The ongoing coronavirus 2019 disease (COVID-19) pandemic strained medical systems worldwide. We report on the impact on pediatric oncology care in Latin American (LATAM) during its first year. Method: Four cross-sectional surveys were electronically distributed among pediatric onco-hematologists in April/June/October 2020, and April/2021 through the Latin American Society of Pediatric Oncology (SLAOP) email list and St Jude Global regional partners. Results: Four hundred fifty-three pediatric onco-hematologists from 20 countries responded to the first survey, with subsequent surveys response rates above 85%. More than 95% of participants reported that treatment continued without interruption for new and active ongoing patients, though with disruptions in treatment availability. During the first three surveys, respondents reported suspensions of outpatient procedures (54.2%), a decrease in oncologic surgeries (43.6%), radiotherapy (28.4%), stem cell transplants (SCT) (69.3%), and surveillance consultations (81.2%). Logistic regression analysis showed that at the beginning of the first wave, participants from countries with healthcare expenditure below 7% were more likely to report a decrease in outpatient procedures (odds ratio [OR]: 1.84, 95% CI: 1.19–2.8), surgeries (OR: 3, 95% CI: 1.9–4.6) and radiotherapy (OR: 6, 95% CI: 3.5–10.4). Suspension of surveillance consultations was higher in countries with COVID-19 case fatality rates above 2% (OR: 3, 95% CI: 1.4–6.2) and SCT suspensions in countries with COVID-19 incidence rate above 100 cases per 100,000 (OR: 3.48, 95% CI: 1.6–7.45). Paradoxically, at the beginning of the second wave with COVID-19 cases rising exponentially, most participants reported improvements in cancer services availability. Conclusion: Our data show the medium-term collateral effects of the pandemic on pediatric oncology care in LATAM, which might help delineate oncology care delivery amid current and future challenges posed by the pandemic. © 2022 Wiley Periodicals LLC.
Una estrategia multimodal para mejorar la atención médica de pacientes pediátricos con cáncer y fiebre en Perú
(Pan American Health Organization, 2023) Mendieta, A; Rios-Lopez, L; Vargas-Arteaga, M; Maradiegue, E; Delgadillo-Arone, W; Rueda-Bazalar, C; Holguin, A; Santillan-Salas, C; Maza, I; Homsi, M; Farias-Barrios, F; Assayag, C; Vásquez, L; Pascual, C; Caniza, M
Objective. The DoTT (Decreasing Time to Therapy) project aimed to minimize the interval between fever onset and medical interventions for children with febrile neutropenia. The objective of this study was to determine the effect of implementing the DoTT project on the hospital time to antibiotic (TTA) and patient time to arrival (PTA) at the hospital in children with febrile neutropenia admitted to the emergency department. Methods. The DoTT project was implemented at a Peruvian hospital and followed the World Health Organi‑ zation (WHO) multimodal improvement strategy model. Components included creating a healthcare delivery bundle and antibiotic selection pathways, training users of the bundle and pathways, monitoring patient out‑ comes and obtaining user feedback, encouraging use of the new system, and promoting the integration of DoTT into the institutional culture. Emergency room providers were trained in the care delivery for children with cancer and fever and taught to use the bundle and pathways. DoTT was promoted via pamphlets and posters, with a view to institutionalizing the concept and disseminating it to other hospital services. Results. Admission data for 129 eligible patients in our registry were analyzed. The TTA and PTA were com‑ pared before and after the DoTT intervention. The median TTA was 146 minutes (interquartile range [IQR] 97–265 minutes) before the intervention in 99 patients, and 69 minutes (IQR 50–120 minutes) afterwards in 30 patients (p<0.01). The median PTA was reduced from 1483 minutes at baseline to 660 minutes after the intervention (p<0.01). Conclusions. Applying the WHO multimodal improvement strategy model to the care of children with febrile neutropenia arriving at the hospital had a positive impact on the PTA and TTA, thus potentially increasing the survival of these patients. © 2023 Pan American Health Organization. All rights reserved.