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Paediatric oncology service delivery and outcomes during the COVID-19 pandemic at the National Cancer Institute, Sudan: a retrospective descriptive study

Year: 2026

Type: article

Abstract: The COVID-19 pandemic disrupted childhood cancer care worldwide, with potentially greater consequences in fragile health systems. We described service utilization, treatment delivery, healthcare access, and clinical outcomes at Sudan’s National Cancer Institute (NCI) during the first pandemic wave and compared selected measures with a 2019 pre-pandemic cohort. We conducted a retrospective descriptive study of 100 children aged 0–15 years who attended the National Cancer Institute between March and September 2020. A 2019 cohort of 120 eligible records from the same calendar interval provided a descriptive pre-pandemic comparator. Multivariable logistic regression models were fitted within the 2020 cohort to examine factors associated with missed appointments, treatment modification, and in-hospital mortality. Mean monthly attendance fell from approximately 75 patients before the pandemic to 17 during the study period (about a 77% reduction). In 2020, 28% of patients had treatment modifications, 26% missed at least one appointment, and in-hospital mortality was 35% (95% CI 25.9–45.1), compared with 18% (95% CI 11.5–26.2) in the 2019 comparator. Advanced-stage disease was recorded in 62% of the 2020 cohort and 58% of the 2019 cohort. Within the 2020 cohort, low socioeconomic status was associated with missed appointments (aOR 3.2, 95% CI 1.4–7.3), treatment modification (aOR 2.8, 95% CI 1.2–6.6), and mortality (aOR 2.6, 95% CI 1.1–6.2). Three patients (3%) tested positive for SARS-CoV-2. This study describes the magnitude of reduced attendance and interrupted treatment in children attending the NCI during the first wave of the pandemic. The difference in mortality from the 2019 comparison is descriptive. Selection into hospital treatment, changes in case mix, and unmeasured clinical characteristics prevent attribution to the pandemic. The findings suggest priorities for emergency preparedness in unstable health systems in terms of access and treatment continuity but do not address whether services and outcomes later recovered. Not applicable.

Source: BMC Health Services Research

DOI: 10.1186/s12913-026-16076-8