Adolescent perspectives towards reproductive health concerns during chemotherapy and radiotherapy treatment at Muhimbili National Hospital, Dar es salam Tanzania

Abstract

ABSTRACT Background: Adolescent age is the peak age of identifying concerns regarding self-identity and sexuality. Concerns about reproductive health are heightened by the potential gonadotoxic effects of chemotherapy and radiation therapy, however they face unique needs and significant challenges including managing their illnesses.Their future life aspirations often exacerbate insecurities particularly concerns on their future reproductive health and potential lifelong toxicities. Adolescents have a limited understanding of fertility health and potential gonadotoxic effects following cancer treatment. Addressing these challenges is vital for their mental health, psychological well-being and ensuring their future childbearing opportunities.Their overall quality of life is of paramount important mostly improving their survivorship. Aim: To explore adolescent perspectives towards reproductive health concerns during chemotherapy and radiotherapy treatment at Muhimbili National Hospital Dar-es-salaam, Tanzania. Methodology: A qualitative study, with descriptive design conducted at the pediatric oncology unit during clinic visits. Participants were adolescents aged 15-19 years and were recruited purposively excluding all critically ill or unconscious participants. Data was collected through in-depth interviews in the Swahili language. Interviews with Semi-structured open-ended guided questions were employed and recorded using audio tapes, later transcription was done verbatim and data information was analyzed using deductive and inductive content analysis. Ethical clearance was sorted by the Research and Ethical Committee of Muhimbili University of Health and Allied Science (MUHAS). Results: A total of 11 participants were enrolled, the majority of them male had secondary education level, participants aged between 15-19 years. Key concerns identified were uncertainties about gonadotoxic effects due to prolonged exposure to systemic therapies, pubertal growth alterations exacerbating concerns about future reproductive ability and they expressed a need for better health knowledge and reassurance about future fertility. Conclusion: Findings have shown that adolescents have reproductive health concerns linked to uncertainties on infertility risks following long-term exposure to mostly systemic therapies leading to pubertal disruptions These concerns are often overlooked at the start of treatment, therefore this study adds knowledge to the existing literature on potential reproductive toxicities and also it provides a voice of expression to this affected population. Keywords: Gonadotoxic side effects, Gonad-toxicity,Reproductive disparities, Infertility risks, Reproductive health concerns, gonadal function, Health Care providers.