Protocol of mixed-methods assessment of demographic, epidemiological and clinical profile of decentralised patients with cancer at Nelson Mandela Academic Hospital and Rob Ferreira Hospital, South Africa

Wezile Chitha; Zukiswa Jafta; Onke R Mnyaka; Danleen Hongoro; Lizo Godlimpi; Buyiswa Swartbooi; Natasha Williams; Christopher Zungu; Lazola Buthi; Sibulelo Kuseni; John Nasila; Siyabonga Sibulawa; Olona Giwu; Awam Mavimbela; Vivien Essel; Sikhumbuzo A Mabunda

doi:10.1136/bmjopen-2021-054983

Protocol of mixed-methods assessment of demographic, epidemiological and clinical profile of decentralised patients with cancer at Nelson Mandela Academic Hospital and Rob Ferreira Hospital, South Africa

BMJ Open. 2022 Apr 21;12(4):e054983. doi: 10.1136/bmjopen-2021-054983.

Authors

Wezile Chitha¹, Zukiswa Jafta¹, Onke R Mnyaka^{2

3}, Danleen Hongoro¹, Lizo Godlimpi⁴, Buyiswa Swartbooi¹, Natasha Williams¹, Christopher Zungu¹, Lazola Buthi⁵, Sibulelo Kuseni⁵, John Nasila^{1

6}, Siyabonga Sibulawa¹, Olona Giwu¹, Awam Mavimbela¹, Vivien Essel¹, Sikhumbuzo A Mabunda^{7

8}

Affiliations

¹ Faculty of Health Sciences, Health Systems Enablement and Innovation, University of the Witwatersrand, Johannesburg, South Africa.
² Faculty of Health Sciences, Health Systems Enablement and Innovation, University of the Witwatersrand, Johannesburg, South Africa onkemnyaka@gmail.com.
³ Economics, Nelson Mandela University, Gqeberha, South Africa.
⁴ Public Health, Walter Sisulu University, Mthatha, South Africa.
⁵ Oncology, Nelson Mandela Academic Hospital, Mthatha, South Africa.
⁶ Statistics, Walter Sisulu University, Mthatha, South Africa.
⁷ The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia.
⁸ School of Population Health, University of New South Wales, Sydney, New South Wales, Australia.

Abstract

Introduction: Cancer is the second leading cause of death globally. However, cancer care services are often concentrated in urban centres. Two of South Africa's hospitals have decentralised cancer care delivery since February 2018 and August 2019, respectively. This study aims to describe the demographic, epidemiological and clinical profile of various cancers at Nelson Mandela Academic Hospital (NMAH) and Rob Ferreira Hospital (RFH), in South Africa's Eastern Cape and Mpumalanga provinces, respectively.

Methods and analysis: This study will be conducted in the Eastern Cape and Mpumalanga provinces. A mixed-methods study design will be undertaken to gain insight on the characteristics of randomly sampled patients who are treated for cancer at NMAH and RFH between 1 March 2018 and 28 February 2022. A validated, researcher-administered survey questionnaire will be used to assess demographic characteristics, and prevalence of different cancers among patients. Concurrently, a document review will be undertaken on patients with cancer using a patient registry to ascertain the duration of diagnosis, type of cancer(s), management plan and patient survival time. STATA V.17 will be used for data analysis. The Shapiro-Wilk test will be used to explore the distribution of numerical variables. The χ² or Fisher's exact tests will be used depending on the value of the expected frequencies to compare categorical variables. Kaplan-Meier survival estimates will be used to determine the survival time. Hazard ratios will be used to determine the predictors of death. The level of statistical significance will be set at p value ≤0.05. The 95% CI will be used for the precision of estimates.

Ethics and dissemination: Ethics approval was obtained from the Human Research Ethics Committees of the University of the Witwatersrand (M210211) and Walter Sisulu University, South Africa (Ref: 040/2020). Findings will be reported through peer-reviewed journal(s), presentations at conferences and at partner meetings.

Keywords: cancer pain; chemotherapy; oncology; radiation oncology.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Delivery of Health Care*
Hospitals
Humans
Neoplasms* / epidemiology
Neoplasms* / therapy
Prevalence
South Africa / epidemiology