Treatment Refusal and Abandonment in Pediatric Patients with Acute Lymphoblastic Leukemia in Bangladesh

Background In developing countries, refusal and abandonment is the main challenge regarding treatment of Acute Lymphoblastic Leukemia (ALL). This study tried to understand and find out the causes of treatment refusal and abandonment in Bangladeshi children with ALL. Methods Over 3 years in Dhaka Shishu (Children) Hospital, all diagnosed children with ALL (12 month to 16 year) were included in this prospective study. Open interviews were conducted with the parents who refused or abandoned treatment about their financial and educational status and causes of refusal or abandonment. This study analyzed the situations from the parental point-of-view. Chi- square test (for parental economic status) was used for statistical analysis. P value less than 0.05 was considered as statistically significant. Results Thirty three percent parents refused to take and 20 % abandoned the treatment. Both were significantly high in children whose parents financial and educational background was low. Preference of traditional healers and fear of prolonged duration and toxicities of chemotherapy are other important causes. Conclusion Poverty and lac of parenteral education is the main cause of treatment refusal and abandonment in Bangladeshi children with ALL.