Al- Anbar Medical Journal

Impact of the COVID-19 Pandemic on Cancer Care in Iraq: Exploratory Research

Document Type : Original articles

Authors

1 Department of Oncology, Anbar Cancer Center, Anbar Health Directorate, Ramadi, Anbar, Iraq.

2 Department of Oncology, King Abdullah International Medical Research Center,King Saud bin Abdulaziz University for Health Sciences, Riyadh, KSA.

3 Department of Community and Environmental Health, College of Public Health and Health Informatics, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, KSA.

4 Cincinnati Cancer Advisors, Cincinnati, Ohio, USA.

5 Radiation Oncology Division, The Ottawa Hospital Cancer Centre, Faculty of Medicine, University of Ottawa, Ontario, Canada. College of Medicine, Nineveh University, Mosul, Ira

Abstract

Background: The COVID-19 pandemic has a tangible impact on the health care systems globallyand is represented by interruption of the usual services in many health facilities and exposingvulnerable patients to significant risks.Objectives: We aimed to evaluate this pandemic’s impact on Iraq’s cancer care.Materials and methods: We conducted an exploratory study using a validated web-basedquestionnaire of 51 items. The questionnaire collected information on the capacity and servicesoffered at the Iraqi cancer centers, the magnitude of care disruption, reasons for the disruption,challenges faced, patient harm estimation, and the interventions implemented during the pandemic.Results: 18 cancer centers from 11 Iraqi governorates took part between 21st April and 8th May2020. These centers were serving around 18,867 new patients per year. Most of them (72.2%)were facing challenges in delivering their care during the pandemic. Although 44.4% of the centersreduced their services as part of a pre-emptive strategy, other reported reasons included lack ofpersonal protective equipment (22.2%), an overwhelmed system (11.1%), and a restricted approachto medications (11.1%). Missing at least one therapy cycle by > 10% of the patients was reportedin 38.9% of the centers. Participants have reported that their patients were exposed to potentialharm from interruption of cancer-specific care (44.4%) and non-cancer-related care (33.3%).Conclusion: The negative impact of the COVID-19 pandemic on cancer care in Iraq is evident.Additional research to estimate such an effect at the patients’ level and the required measures tocounteract this problem is vital.

Keywords

Main Subjects

References
[1]      H. Lu, C. W. Stratton, and Y.-W. Tang, “Outbreak of pneumonia of unknown etiology in Wuhan, China: The mystery and the miracle,” J. Med. Virol., vol. 92, no. 4, pp. 401–402, Apr. 2020, doi: https://doi.org/10.1002/jmv.25678.
[2]      World Health Organization, “WHO Director-General’s opening remarks at the media briefing on COVID-19 - 11 March 2020,” WHO Director General, 11-Mar-2020. [Online]. Available: https://www.who.int/director-general/speeches/detail/who-director-general-s-opening-remarks-at-the-media-briefing-on-covid-19---11-march-2020. [Accessed: 06-Dec-2020].
[3]      Corona Virus Resource Center, “COVID-19 Dashboard by the Center for Systems Science and Engineering (CSSE) at Johns Hopkins University (JHU),” Johns Hopkins, 06-Dec-2020. [Online]. Available: https://coronavirus.jhu.edu/map.html. [Accessed: 06-Dec-2020].
[4]      A. R. Jazieh et al., “Oncologists knowledge, attitude and practice in COVID-19 pandemic and its negative impact on them: An international study,” Ann. Oncol., vol. 31, Sep. 2020, doi: 10.1016/j.annonc.2020.08.1751.
[5]      J. van de Haar et al., “Caring for patients with cancer in the COVID-19 era,” Nat. Med., vol. 26, no. 5, pp. 665–671, 2020, doi: 10.1038/s41591-020-0874-8.
[6]      D. Schrag, D. L. Hershman, and E. Basch, “Oncology Practice During the COVID-19 Pandemic,” JAMA, vol. 323, no. 20, pp. 2005–2006, May 2020, doi: 10.1001/jama.2020.6236.
[7]      C.-L. Bong, C. Brasher, E. Chikumba, R. McDougall, J. Mellin-Olsen, and A. Enright, “The COVID-19 Pandemic: Effects on Low- and Middle-Income Countries,” Anesth. Analg., vol. 131, no. 1, 2020.
[8]      Iraqi Cancer Board, Cancer care regulations in Iraq during COVID-19 pandemic. Baghdad: Ministry of Health, 2020.
[9]      A. R. Jazieh et al., “The impact of COVID-19 pandemic on cancer care: A global collaborative study,” Ann. Oncol., vol. 31, Sep. 2020, doi: 10.1016/j.annonc.2020.08.2325.
[10]    A. R. Jazieh et al., “Impact of the COVID-19 Pandemic on Cancer Care: A Global Collaborative Study,” JCO Glob. Oncol., vol. 6, 2020, doi: 10.1200/GO.20.00351.
[11]    S. J. Nidhamalddin, R. O. Hasan, and G. O. Abubakr, “Cancer treatment during the COVID-19 pandemic in the Kurdistan Region of northern Iraq,” Ecancermedicalscience, vol. 14, Sep. 2020, doi: 10.3332/ecancer.2020.1096.
[12]    K. de Joode et al., “Impact of the coronavirus disease 2019 pandemic on cancer treatment: the patients’ perspective,” Eur. J. Cancer, vol. 136, pp. 132–139, Sep. 2020, doi: 10.1016/j.ejca.2020.06.019.
[13]    R. Saab et al., “Impact of the coronavirus disease 2019 (COVID‐19) pandemic on pediatric oncology care in the Middle East, North Africa, and West Asia region: A report from the Pediatric Oncology East and Mediterranean (POEM) group,” Cancer, vol. 126, no. 18, Sep. 2020, doi: 10.1002/cncr.33075.
[14]    T. P. Hanna, G. A. Evans, and C. M. Booth, “Cancer, COVID-19 and the precautionary principle: prioritizing treatment during a global pandemic,” Nat. Rev. Clin. Oncol., vol. 17, no. 5, May 2020, doi: 10.1038/s41571-020-0362-6.
[15]    American Society of Clinical Oncology, “A Guide to Cancer Care Delivery During the COVID-19 Pandemic,” Alexandria, May 2020.
[16]    European Society for Medical Oncology, “Cancer Patient Management During the COVID-19 Pandemic,” ESMO Recommendations, 2020. [Online]. Available: https://www.esmo.org/guidelines/cancer-patient-management-during-the-covid-19-pandemic?page=1. [Accessed: 06-Dec-2020].
[17]    H. O. Al‐Shamsi et al., “A Practical Approach to the Management of Cancer Patients During the Novel Coronavirus Disease 2019 (COVID-19) Pandemic: An International Collaborative Group,” Oncologist, vol. 25, no. 6, Jun. 2020, doi: 10.1634/theoncologist.2020-0213.
[18]    Z. Benbrahim et al., “National approaches to managing cancer care: Responses of countries in the MENA region to COVID-19 pandemic,” Ann. Oncol., vol. 31, Sep. 2020, doi: 10.1016/j.annonc.2020.08.1801.
[19]    L. C. Abu Esba, H. A. Al-Abdulkarim, A. Alrushidan, and M. Al Harbi, “Pharmacy and Therapeutics Committee Preparedness Plan for COVID-19,” Glob. J. Qual. Saf. Healthc., vol. 3, no. 2, May 2020, doi: 10.36401/JQSH-20-9.
[20]    European Medicines Agency, “Availability of medicines during COVID-19 pandemic,” European Medicines Agency, 2020. [Online]. Available: https://www.ema.europa.eu/en/human-regulatory/overview/public-health-threats/coronavirus-disease-covid-19/availability-medicines-during-covid-19-pandemic. [Accessed: 19-Dec-2020].
[21]    Food and Drug Administration, “Drug Shortages,” FDA, 2020. [Online]. Available: https://www.fda.gov/drugs/drug-safety-and-availability/drug-shortages. [Accessed: 19-Dec-2020].
[22]    H. Bauchner, P. B. Fontanarosa, and E. H. Livingston, “Conserving Supply of Personal Protective Equipment—A Call for Ideas,” JAMA, vol. 323, no. 19, p. 1911, May 2020, doi: 10.1001/jama.2020.4770.
[23]    J. M. Marron, S. Joffe, R. Jagsi, R. A. Spence, and F. J. Hlubocky, “Ethics and Resource Scarcity: ASCO Recommendations for the Oncology Community During the COVID-19 Pandemic,” J. Clin. Oncol., vol. 38, no. 19, pp. 2201–2205, Apr. 2020, doi: 10.1200/JCO.20.00960.
[24]    M. L. Ranney, V. Griffeth, and A. K. Jha, “Critical Supply Shortages — The Need for Ventilators and Personal Protective Equipment during the Covid-19 Pandemic,” N. Engl. J. Med., vol. 382, no. 18, Apr. 2020, doi: 10.1056/NEJMp2006141.
[25]    M. Richards, M. Anderson, P. Carter, B. L. Ebert, and E. Mossialos, “The impact of the COVID-19 pandemic on cancer care,” Nat. Cancer, vol. 1, no. 6, pp. 565–567, 2020, doi: 10.1038/s43018-020-0074-y.
[26]    K. S. Saini et al., “Effect of the COVID-19 pandemic on cancer treatment and research.,” Lancet. Haematol., vol. 7, no. 6, pp. e432–e435, Jun. 2020, doi: 10.1016/S2352-3026(20)30123-X.
[27]    R. S. Hoehn and A. H. Zureikat, “Cancer disparities in the COVID‐19 era,” J. Surg. Oncol., vol. 122, no. 3, Sep. 2020, doi: 10.1002/jso.26043.
[28]    T. J. Royce, H. K. Sanoff, and A. Rewari, “Telemedicine for Cancer Care in the Time of COVID-19,” JAMA Oncol., vol. 6, no. 11, Nov. 2020, doi: 10.1001/jamaoncol.2020.2684.
[29]    Iraqi Cancer Registry, “2018 Annual Report - Iraqi Cancer Registry,” Baghdad, 2018.
[30]    Z. Bakouny et al., “COVID-19 and Cancer: Current Challenges and Perspectives,” Cancer Cell, vol. 38, no. 5, Nov. 2020, doi: 10.1016/j.ccell.2020.09.018.
 
 
Al- Anbar Medical Journal
Volume 17, Issue 1
June 2021
Page 9-15
Files
Share
Export Citation
Statistics