The Wilms Africa Project
Improving care and survival since 2006
Wilms tumour (WT) is one of the common and curable cancer types targeted by the Global Initiative for Childhood Cancer. The Wilms Africa Project has been developing, implementing and evaluating adapted treatment guidelines for Wilms tumour in low-income countries, especially sub-Saharan Africa, aiming to improve care and survival.
It started with a pilot project in Blantyre, Malawi where from 2006 - 2008 an adapted treatment guideline, including preoperative chemotherapy, nutritional support and strategies to enable families to complete treatment was introduced. This programme was associated with an increase in completion of treatment, survival and created essential local evidence.
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Based upon the findings in Malawi and the international guidelines for the treatment of Wilms tumour in Europe and North America a SIOP PODC consensus treatment guideline was published in 2013 which was used for the Wilms Africa Phase I (2014 - 2018) project in which 4 hospitals in sub-Saharan Africa participated.
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The Wilms Africa Phase I project showed improved end-of-treatment disease-free survival (68.5% vs 52%, P=0.002) and reduced treatment abandonment (12% vs 23%, P = 0.009). Two-year event free survival was 49.9%.
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Wilms Africa Phase II started in January 2021, with the participation of seven hospitals in Malawi, Ethiopia, Ghana, Cameroon and Zimbabwe and using a revised and more comprehensive adapted treatment guideline.
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Please find the most recent publication about the project and this overall improved survival of children with Wilms tumour here.
Please find a short video of the presentation at the SIOP 2020 conference on the Wilms Africa project by Dr Vivian Paintsil here (kindly create a CaseHippo user account to access the content free of charge).
Here is a short video about the project and it’s impact:
Leadership
The Wilms Africa (Phase II) programme is led by Dr. Trijn Israels (Blantyre, Malawi), Chair and Principal Investigator (PI), Cecilia Mdoka (Blantyre, Malawi), Central Data Manager and Dr Vivian Paintsil (Kumasi, Ghana), Deputy-Chair. Prof Kathy Pritchard-Jones (London, UK and Previous Chair of the SIOP Renal Tumour Study Group and Previous SIOP President) is an advisor.
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Trijn Israels:
Collaborative Wilms Tumour Africa Project
Glenn Mbah:
Collaborative Wilms Tumour Africa Project
Global Health Childhood Cancer PodcastAudio Player
Results, impact and publications
The Wilms Africa Phase I project showed improved end-of-treatment disease-free survival (68.5% vs 52%, P=0.002) and reduced treatment abandonment (12% vs 23%, P = 0.009). Two-year event free survival was 49.9% with treatment abandonment considered as an event.
Publications Wilms Africa Project
for further reading from the group
Treatment guidelines
Please find here the link to multi-disciplinary, consensus adapted treatment guideline for Wilms Tumour and supportive care in low-income countries published in 2013. These guidelines are produced by a working group of the SIOP Committee for Pediatric Oncology in Developing Countries (PODC), in those years chaired by Dr Guillermo Chantada and Dr Trijn Israels.
Please find here the link to a more comprehensive and revised adapted treatment guideline for Wilms tumour in sub-Saharan Africa (and other low-income countries). This guideline is made available online on the SIOP website in 2020 and produced by the Wilms Africa group with input from multi-disciplinary experts from all over the world.
Both guidelines are widely used worldwide to guide clinicians in low-income countries regarding the treatment of children with Wilms tumour.
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Collaborative Wilms Tumour Africa Project – Phase II (2021)
Phase II of the Collaborative Wilms Tumour Africa Project started in January 2021 and is implementing a revised and more comprehensive adapted treatment guideline. The revisions include guidance for radiotherapy (if available), optional longer postoperative chemotherapy and guidance for treatment of children with a relapse of disease. The revised and comprehensive guideline can be found here.
Seven hospitals in Malawi, Ghana, Cameroon, Ethiopia and Zimbabwe are participating. All sites have local project and data managers with dedicated time, funded by grants from the SIOP Programme to Advance Research Capacity (SIOP PARC) and My Child Matters from Foundation S (previously Sanofi Espoir). Data collection has been >95% complete.
Contact
If you are interested and / or would like to support this initiative - please contact us.
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Acknowledgement
We are grateful for the funding from the SIOP board and the Foundation S (My Child Matters).