Maternally Orphaned Children and Intergenerational Concerns Associated With Breast Cancer Deaths Among Women in Sub-Saharan Africa.
Maternally Orphaned Children and Intergenerational Concerns Associated With Breast Cancer Deaths Among Women in Sub-Saharan Africa.
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DOI：
10.1001/jamaoncol.2020.6583
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发表时间：
2021-02-01
期刊：
影响因子：
28.4
通讯作者：
McCormack V
中科院分区：
文献类型：
--
作者：
Galukande M;Schüz J;Anderson BO;Zietsman A;Adisa C;Anele A;Parham G;Pinder LF;Mutumba S;Lombe D;Cabanes A;Foerster M;Dos-Santos-Silva I;McCormack V
2014-2019年，撒哈拉以南非洲地区每100例乳腺癌死亡造成多少名孕产妇孤儿？在非洲乳腺癌-乳腺癌妇女结局差异队列研究中，在纳米比亚、尼日利亚、乌干达和赞比亚，孕产妇死亡时仍有964名儿童（<18岁）和795名妇女死亡。这些产妇死亡中有一半是50岁以下的妇女，在这一年龄组中，每100名死于乳腺癌的儿童中，就有210名成为产妇孤儿。这项研究的结果量化了撒哈拉以南非洲母亲死于乳腺癌的儿童中与癌症死亡相关的代际后果。撒哈拉以南非洲年轻人口中乳腺癌存活率低增加了乳腺癌死亡导致母亲孤儿的可能性，即儿童（<18岁）失去母亲。估计2014-2019年期间撒哈拉以南非洲地区每100例乳腺癌死亡的孕产妇孤儿人数及其年龄，并描述家庭对孤儿的担忧。2014年9月1日至2019年7月1日期间发生的非洲乳腺癌结局差异（ABC-DO）死亡事件，在2014-2017年期间在纳米比亚，尼日利亚，乌干达和赞比亚的主要癌症治疗医院诊断为乳腺癌的女性队列中进行了检查。通过每三个月一次的移动的电话，对每个妇女或她的近亲（通常是伴侣、丈夫或孩子）进行生命状态的积极随访。产妇死亡时新生孤儿的数量（泊松计数）和年龄。这项队列研究发现，共有795人死亡，导致964名新的产妇孤儿，其中50岁以下的妇女死亡占孤儿的85%。在50岁以下的妇女中，每100例死亡，总体上有210例新的孤儿（95% CI，196-225），具体国家估计数为尼日利亚189例，纳米比亚180例，乌干达222例，赞比亚黑人妇女247例。每100名任何年龄段的妇女死亡，就有121名产妇孤儿，其中17%在产妇死亡时年龄在5岁以下，32%在5至9岁，51%在10至17岁。在后续访谈中，据报告，家庭对子女教育和儿童保育的关切因与癌症治疗有关的财务费用而加剧。这项研究提供的证据表明，在撒哈拉以南非洲，因乳腺癌而成为孤儿的产妇人数超过了因乳腺癌死亡的妇女人数。在撒哈拉以南非洲，与癌症死亡有关的代际后果似乎很大，支持继续采取行动改善生存的必要性。这项队列研究估计了4个撒哈拉以南非洲国家妇女死于乳腺癌时的孕产妇孤儿人数。
How many maternal orphans resulted from every 100 breast cancer deaths in sub-Saharan African settings in 2014-2019? In the African Breast Cancer–Disparities in Outcomes cohort study of women with breast cancer, there were 964 children (<18 years) remaining at the time of maternal death and 795 deaths of women in Namibia, Nigeria, Uganda, and Zambia. Half of these maternal deaths occurred in women younger than 50 years and, for every 100 breast cancer deaths in this age group, 210 children became maternal orphans. The results of this study quantify the intergenerational consequences associated with cancer death among children in Sub-Saharan Africa whose mothers die from breast cancer. Low breast cancer survival in sub-Saharan Africa’s young population increases the likelihood that breast cancer deaths result in maternal orphans, ie, children (<18 years) losing their mother. To estimate the number of maternal orphans and their ages for every 100 breast cancer deaths in sub-Saharan African settings during 2014-2019 and to describe family concerns about the orphaned children. Deaths occurring between September 1, 2014, and July 1, 2019, in the African Breast Cancer–Disparities in Outcomes (ABC-DO) were examined in a cohort of women diagnosed with breast cancer during 2014-2017 at major cancer treatment hospitals in Namibia, Nigeria, Uganda, and Zambia. The cohort was actively followed up for vital status via a trimonthly mobile phone call to each woman or her next of kin (typically a partner, husband, or child). The number (Poisson counts) and ages of new orphans at the time of maternal death. This cohort study found that a total of 795 deaths resulted in 964 new maternal orphans, with deaths occurring in women younger than 50 years accounting for 85% of the orphans. For every 100 deaths in women younger than 50 years, there were 210 new orphans (95% CI, 196-225) overall, with country-specific estimates of 189 in Nigerian, 180 in Namibian, 222 in Ugandan, and 247 in Zambian Black women. For every 100 deaths of the women at any age, there were 121 maternal orphans, 17% of whom were younger than 5 years, 32% aged 5 to 9 years, and 51% aged 10 to 17 years at the time of maternal death. In follow-up interviews, families’ concerns for children’s education and childcare were reported to be exacerbated by the financial expenses associated with cancer treatment. This study provides evidence that the number of maternal orphans due to breast cancer exceeds the number of breast cancer deaths among women in sub-Saharan Africa. The intergenerational consequences associated with cancer deaths in sub-Saharan Africa appear to be large and support the need for continued action to improve survival. This cohort study estimates the number of maternal orphans in 4 sub-Saharan Africa countries when women die of breast cancer.
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影响因子：
3
作者：
Embleton, Lonnie;Ayuku, David;Braitstein, Paula
通讯作者：
Braitstein, Paula
影响因子：
5
作者：
Foerster, Milena;Anele, Angelica;McCormack, Valerie
通讯作者：
McCormack, Valerie
DOI：
10.1016/s0140-6736(17)33326-3
发表时间：
2018-03-17
期刊：
Lancet (London, England)
影响因子：
--
作者：
Allemani C;Matsuda T;Di Carlo V;Harewood R;Matz M;Nikšić M;Bonaventure A;Valkov M;Johnson CJ;Estève J;Ogunbiyi OJ;Azevedo E Silva G;Chen WQ;Eser S;Engholm G;Stiller CA;Monnereau A;Woods RR;Visser O;Lim GH;Aitken J;Weir HK;Coleman MP;CONCORD Working Group
通讯作者：
CONCORD Working Group
影响因子：
6.2
作者：
Vega, Raymond B. Mailhot;Balogun, Onyinye D.;Formenti, Silvia C.
通讯作者：
Formenti, Silvia C.
影响因子：
3.5
作者：
Evans, David K.;Miguel, Edward
通讯作者：
Miguel, Edward