EPID-01. PEDIATRIC BRAIN TUMORS IN SUB-SAHARAN AFRICA:A SYSTEMATIC REVIEW AND META-ANALYSIS

Abstract OBJECTIVE brain tumors are a global problem, leading to higher cancer-related morbidity and mortality rates in children. Despite the progressive though slow advances in neuro-oncology care, research, and diagnostics in sub-Saharan Africa (SSA), the epidemiological landscape of pediatric brain tumors (PBTs) remains underestimated. This study aimed to systematically analyze the distribution of PBT types in SSA. METHODS major databases and grey literature were searched for literature on PBTs in SSA published before October 29, 2022. A proportional meta-analysis was performed. RESULTS forty-nine studies, involving 2360 children, met the inclusion criteria for review; only 20 (40.82%) were included in the quantitative analysis. South Africa and Nigeria were the countries with the most abundant data. Glioma not otherwise specified (NOS) was the common PBT in the 4 SSA regions combined. However, medulloblastoma was more commonly reported in Southern-SSA(p=0.01) than in other regions. The prevalence and the overall pooled proportion of the 3 common PBTs was estimated at 46.27% and 0.41 (95%CI 0.32–0.50, 95% prediction interval [PI] 0.11–0.79), 25.34% and 0.18 (95%CI 0.14–0.21, 95%PI 0.06–0.40), and 12.67% and 0.12 (95%CI 0.09–0.15, 95%PI 0.04–0.29) for glioma-NOS, medulloblastoma, and craniopharyngioma, respectively. Sample size moderated the estimated proportion of glioma-NOS (p = 0.02). The highest proportion of craniopharyngiomas was in Western-SSA, and medulloblastoma and glioma-NOS in Central-SSA. CONCLUSION these findings provide insight into the trends of PBT types and the proportion of the top 3 most common tumors across SSA. Although statistical conclusions are difficult due to the inconsistency in the data. We identify critical areas for policy development and collaborations that can facilitate improved outcomes in PBTs in SSA. More accurate epidemiological studies are needed to better understand the burden of the disease and the geographic variation in their distribution, and to raise awareness in their subsequent management.