Depression and Complicated Grief Among Parents of Pediatric Cancer Patients in Cameroon: Implications for Global Health in Low-income Countries

Background and Objectives Bereaved parents of pediatric cancer patients frequently experience severe grief and psychological distress, but studies on the prevalence of major depressive disorder (MDD) and complicated grief (CG) among this population in Cameroon are lacking. This study aimed to determine the prevalence of MDD and CG among bereaved parents of deceased pediatric cancer patients treated at Mbingo Baptist Hospital Cameroon, and to identify predictors of these mental health outcomes.

This cross-sectional study included parents of deceased pediatric cancer patients treated at Mbingo Baptist Hospital between January 2015 and January 2022. Multivariate logistic regression identified predictors of MDD and CG as adjusted odds ratios (AOR) with 95% confidence intervals (CIs).

The prevalence of CG in this population was 86%, while 66.7% of the study subjects screened positive for MDD. Significant predictors of MDD included age [OR 1.091, p=0.018], financial hardship [OR 9.47, p=0.014], accurate knowledge of the child’s prognosis [OR 0.268, p=0.046], perceived social support [(poor social support OR 6.402, P=0.039), (moderate social support OR 8.556, p=0.045)], and coping capacity [medium resilient copers OR 7.874, p=0.027]. Predictors of CG included age [OR 1.157, p=0.032], financial hardship [OR 11.501, p=0.04], years passed since child loss [1-2 years OR 4.634, p=0.049], and coping capacity [(low resilient copers OR 14.011, p<0.01), (medium resilient copers OR 19.023, p<0.01)].

The study revealed high prevalence of MDD and CG among bereaved parents of pediatric cancer patients in Cameroon. Financial difficulty, social support, and coping capacity had substantial impact on parental mental health outcomes in this population. Personalized mental health support services into pediatric oncology care is critical for assisting bereaved families and encouraging resilience in the face of loss may improve health and wellbeing of the families. The study may have implications for global mental health in similar low-income countries. Competing Interest Statement The authors have declared no competing interest. Funding Statement This study was supported by Grant Number R25CA112383 from the National Cancer Institute. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Cancer Institute or the National Institutes of Health. Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: IRB approval was obtained from Cameroon Baptist Convention Health IRB I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes Data Availability Data will be made available upon reasonable request to the corresponding author.