Profile Of Infectious Complications in Pediatric Oncology Patients: Experience from Tertiary Referral Hospital in Low and Middle-Income Country

Abstract Background Cancer patients are at higher risk of infections and more likely to have higher morbidity and mortality than the general population, While cancer itself is still the main cause of death in children around the world, in countries with limited health facilities, that might cause delay in seeking treatment, cancer death rate in children could reach 90%; most of them are caused by infectious complications such as typhilitis and mucositis, and febrile neutropenia might contribute to it. The aim of the study was to describe that infectious complications that occur in pediatric oncology patients does correlate with febrile neutropenia and prognosis. Methods We collected data using Hospital Information System from October 1, 2022, to October 31, 2023, in pediatric oncology patients aged 1 to 18 years admitted to Hasan Sadikin General Hospital. Data collected included patient characteristics, diagnosis, typhlitis and mucositis, and neutropenia. Mortality data were also collected after auditing by experts from Hasan Sadikin General Hospital. Results There were 1982 pediatric oncology patients admitted, 90 (4,5%) were consulted to infectious diseases because of neutropenia; most of these patients (34.4%) were diagnosed with acute myeloblastic leukemia, with acute lymphoblastic leukemia second (24,4%). Most of the patients were <5 years old (42,25%); 77/90 (85,5%) had ANC<500 and most were categorized as high-risk group 62/77 (80,5%). Mucositis and typhlitis occurred more commonly in this group with 17/67 (25,3%) and 2/67 (2,9 %) respectively compared to 3 cases of mucositis and no case of typhlitis in the low-risk group. Mortality rate was 10,4% (7/67) in the high-risk group, and all of them had mucositis and/or typhlitis. Conclusion Better quality of care including infection prevention and control is important, especially in high-risk group population with low ANC because infectious complications such as typhlitis and mucositis are much likely to occur and could affect prognosis.