Study of Factors Affecting the Time to Diagnosis and Treatment in Pediatric Acute Leukemia Patients- A study from India

Timely diagnosis and early initiation of treatment of acute leukemia in children improve survival. Our study aimed to identify the factors associated with delayed diagnosis of acute leukemia in children. A prospective observational study was done at a tertiary care Superspeciality hospital in Northern India. The study included 100 children aged 0–12 years over 18 months with the diagnosis of acute leukemia. A mixed-methods technique was used, combining important variables with qualitative interviews. The primary caregivers of each patient were asked to fill out a standardized questionnaire for this study in addition to the information recorded in the case record form, Demographic, clinical, and Healthcare system data were documented. Patient, physician, and health care system factors that cause delayed diagnosis were studied. Female sex (p-value – 0.003), the primary response to illness (p-value <0.001), lower socio-economic strata, and traveling Time to the nearest health care facility of more than   20-40 minutes were significant factors identified as the reason for the delay in acute leukemia diagnosis by more than eight weeks. There is a significant time lag between the onset of the first symptom and diagnosis of acute leukemia which may adversely affect the outcome. A concerted effort to improve the health care system and raise awareness of signs and symptoms of acute leukemia among caregivers and primary care physicians is required.