IMPACT OF COVID-19 CONTAINMENT MEASURES ON CHILDREN WITH CANCER IN INDONESIA

Background and Aims: COVID-19 containment measures to limit COVID-19 spreading profoundly impact children around the globe, especially in low- and middle-income countries such as Indonesia. The aim of this case series study is to uncover the impact that COVID-19 containment measures have on Indonesian children with cancer and their families.
Methods: A case series study was conducted in July 2021. Investigators identified three children diagnosed with cancer at an Indonesian referral hospital and studied their medical records. Caretakers were interviewed inside the hospital by an independent interviewer using a semi-structured questionnaire.
Results: This study presents three children with cancer and their families. Access to proper healthcare was hindered during the COVID-19 pandemic due to mobility restrictions, medical staff shortage, limited chemotherapy and blood products availability, postponed medical procedures, and delayed or modified treatment administration. Financial hardships resulted because caretakers lost their jobs due to the lock-downs and that medication costs were no longer fully covered by health-insurance. Children and their relatives suffered from mental health issues. Anxiety, depression, stress and loneliness were caused by the fear of receiving suboptimal cancer treatment, serious concerns about financial difficulties, and restricted social interactions. All families believed that COVID-19 containment measures worsened their children’s survival chances.
Conclusions: COVID-19 containment measures adversely impact children with cancer and their families in Indonesia, and most likely in other low- and middle-income countries as well. Disruptions in timely and adequate childhood cancer treatment administration may importantly deteriorate survival chances. Governments and policymakers should take these indirect effects into account to protect vulnerable children and their families.