Abstract：
OBJECTIVE: Brain tumors are a global problem, leading to higher cancer-related morbidity and mortality rates in children. Despite the progressive though slow advances in neuro-oncology care, research, and diagnostics in sub-Saharan Africa (SSA), the epidemiological landscape of pediatric brain tumors (PBTs) remains underestimated. This study aimed to systematically analyze the distribution of PBT types in SSA.
METHODS: Ovid Medline, Global Index Medicus, African Journals Online, Google Scholar, and faculty of medicine libraries were searched for literature on PBTs in SSA published before October 29, 2022. A proportional meta-analysis was performed.
RESULTS: Forty-nine studies, involving 2360 children, met the inclusion criteria for review; only 20 (40.82%) were included in the quantitative analysis. South Africa and Nigeria were the countries with the most abundant data. Glioma not otherwise specified (NOS) was the common PBT in the 4 SSA regions combined. However, medulloblastoma was more commonly reported in Southern SSA (p = 0.01) than in other regions. The prevalence and the overall pooled proportion of the 3 common PBTs was estimated at 46.27% and 0.41 (95% CI 0.32-0.50, 95% prediction interval [PI] 0.11-0.79), 25.34% and 0.18 (95% CI 0.14-0.21, 95% PI 0.06-0.40), and 12.67% and 0.12 (95% CI 0.09-0.15, 95% PI 0.04-0.29) for glioma NOS, medulloblastoma, and craniopharyngioma, respectively. Sample size moderated the estimated proportion of glioma NOS (p = 0.02). The highest proportion of craniopharyngiomas was in Western SSA, and medulloblastoma and glioma NOS in Central SSA.
CONCLUSIONS: These findings provide insight into the trends of PBT types and the proportion of the top 3 most common tumors across SSA. Although statistical conclusions are difficult due to the inconsistency in the data, the study identifies critical areas for policy development and collaborations that can facilitate improved outcomes in PBTs in SSA. More accurate epidemiological studies of these tumors are needed to better understand the burden of the disease and the geographic variation in their distribution, and to raise awareness in their subsequent management.
METHODS: Ovid Medline, Global Index Medicus, African Journals Online, Google Scholar, and faculty of medicine libraries were searched for literature on PBTs in SSA published before October 29, 2022. A proportional meta-analysis was performed.
RESULTS: Forty-nine studies, involving 2360 children, met the inclusion criteria for review; only 20 (40.82%) were included in the quantitative analysis. South Africa and Nigeria were the countries with the most abundant data. Glioma not otherwise specified (NOS) was the common PBT in the 4 SSA regions combined. However, medulloblastoma was more commonly reported in Southern SSA (p = 0.01) than in other regions. The prevalence and the overall pooled proportion of the 3 common PBTs was estimated at 46.27% and 0.41 (95% CI 0.32-0.50, 95% prediction interval [PI] 0.11-0.79), 25.34% and 0.18 (95% CI 0.14-0.21, 95% PI 0.06-0.40), and 12.67% and 0.12 (95% CI 0.09-0.15, 95% PI 0.04-0.29) for glioma NOS, medulloblastoma, and craniopharyngioma, respectively. Sample size moderated the estimated proportion of glioma NOS (p = 0.02). The highest proportion of craniopharyngiomas was in Western SSA, and medulloblastoma and glioma NOS in Central SSA.
CONCLUSIONS: These findings provide insight into the trends of PBT types and the proportion of the top 3 most common tumors across SSA. Although statistical conclusions are difficult due to the inconsistency in the data, the study identifies critical areas for policy development and collaborations that can facilitate improved outcomes in PBTs in SSA. More accurate epidemiological studies of these tumors are needed to better understand the burden of the disease and the geographic variation in their distribution, and to raise awareness in their subsequent management.
摘要：
目的：脑肿瘤是一个全球性问题，导致儿童癌症相关的发病率和死亡率更高。尽管神经肿瘤治疗进展缓慢，研究,和撒哈拉以南非洲(SSA)的诊断，小儿脑肿瘤(PBT)的流行病学前景仍被低估.本研究旨在系统分析SSA中PBT类型的分布。
方法：OvidMedline，全球指数Medicus，非洲在线期刊，谷歌学者，在2022年10月29日之前发表的SSA中搜索了关于PBT的文献。进行了比例荟萃分析。
结果：49项研究，涉及2360名儿童，符合纳入审查标准;只有20例(40.82%)被纳入定量分析.南非和尼日利亚是数据最丰富的国家。未另作说明的神经胶质瘤（NOS）是4个SSA区域合并的常见PBT。然而,在南部SSA（p=0.01）中，髓母细胞瘤比其他地区更常见。3种常见PBT的患病率和总体合并比例估计为46.27%和0.41(95%CI0.32-0.50,95%预测区间[PI]0.11-0.79),25.34%和0.18（95%CI0.14-0.21，95%PI0.06-0.40），神经胶质瘤NOS为12.67%和0.12（95%CI0.09-0.15，95%PI0.04-0.29），髓母细胞瘤,和颅咽管瘤,分别。样本量降低了神经胶质瘤NOS的估计比例（p=0.02）。颅咽管瘤的比例最高的是西部SSA，和中央SSA的髓母细胞瘤和神经胶质瘤NOS。
结论：这些发现提供了对整个SSA中PBT类型和前3个最常见肿瘤比例的趋势的了解。尽管由于数据的不一致，难以得出统计结论，该研究确定了政策制定和合作的关键领域，这些领域可以促进SSA中PBT的改善成果。需要对这些肿瘤进行更准确的流行病学研究，以更好地了解疾病的负担及其分布的地理差异，并提高其后续管理的意识。
方法：OvidMedline，全球指数Medicus，非洲在线期刊，谷歌学者，在2022年10月29日之前发表的SSA中搜索了关于PBT的文献。进行了比例荟萃分析。
结果：49项研究，涉及2360名儿童，符合纳入审查标准;只有20例(40.82%)被纳入定量分析.南非和尼日利亚是数据最丰富的国家。未另作说明的神经胶质瘤（NOS）是4个SSA区域合并的常见PBT。然而,在南部SSA（p=0.01）中，髓母细胞瘤比其他地区更常见。3种常见PBT的患病率和总体合并比例估计为46.27%和0.41(95%CI0.32-0.50,95%预测区间[PI]0.11-0.79),25.34%和0.18（95%CI0.14-0.21，95%PI0.06-0.40），神经胶质瘤NOS为12.67%和0.12（95%CI0.09-0.15，95%PI0.04-0.29），髓母细胞瘤,和颅咽管瘤,分别。样本量降低了神经胶质瘤NOS的估计比例（p=0.02）。颅咽管瘤的比例最高的是西部SSA，和中央SSA的髓母细胞瘤和神经胶质瘤NOS。
结论：这些发现提供了对整个SSA中PBT类型和前3个最常见肿瘤比例的趋势的了解。尽管由于数据的不一致，难以得出统计结论，该研究确定了政策制定和合作的关键领域，这些领域可以促进SSA中PBT的改善成果。需要对这些肿瘤进行更准确的流行病学研究，以更好地了解疾病的负担及其分布的地理差异，并提高其后续管理的意识。
