ID #895 Epidemiologic profile and temporal changes of pediatric central nervous system tumors in Kenya: A 15-Year Analysis from a National Referral Hospital
Philip Mwachaka, Minda Okemwa, Scott Coven, Sarah Leary, Dalton WamalwaAbstract
Background
Pediatric central nervous system (CNS) tumors are the leading cause of cancer-related mortality in children, yet long-term epidemiologic data from low- and middle-income countries (LMICs) remain limited. Understanding tumor patterns in these settings is essential to inform equitable pediatric neuro-oncology care. We describe the histologic spectrum and temporal trends of pediatric CNS tumors over 15 years at Kenya’s national referral hospital.
Methods
We conducted a retrospective review of children ≤18 years with histologically confirmed CNS tumors treated surgically at Kenyatta National Hospital between 2010 and 2024. Demographic, histologic, tumor grade, anatomic location, and year of diagnosis were extracted from pathology records. Tumors were classified according to WHO CNS5; diagnoses requiring molecular confirmation were recorded as not otherwise specified due to the absence of molecular testing. Temporal trends were analyzed by calendar year and aggregated 5-year periods.
Results
A total of 404 pediatric CNS tumors were identified. Gliomas were the most common tumors (41.1%), followed by embryonal tumors (32.2%), with medulloblastoma accounting for nearly one-quarter of all cases. Low-grade tumors comprised 58.4% overall and increased significantly over time (55.0% in 2010–2014 vs 61.7% in 2020–2024; p < 0.001). Annual surgical case volume rose steadily, peaking in 2021. Notably, the proportion of tumors diagnosed in children aged 0–4 years increased from 22.6% to 35.1% across the study period. Supratentorial and infratentorial tumors were nearly equally represented.
Conclusions
This study provides the most comprehensive longitudinal characterization of pediatric CNS tumors in Kenya to date and highlights evolving tumor patterns in an LMIC setting. Rising detection of low-grade tumors and increasing diagnoses in very young children suggest improving access to care, while reliance on histology alone underscores persistent diagnostic gaps. Multi-center survival analyses across Kenyan referral hospitals are ongoing. These findings emphasize opportunities for global collaboration to strengthen pediatric neuro-oncology capacity and improve outcomes in resource-limited settings.