Nutritional status, feeding practices, and existing nutritional support among children with cancer, Pediatric Oncology Unit, Muhimbili National Hospital (MNH), Dar es Salaam, Tanzania; Prospective Cohort Study

Abstract

Background: More than 85% of childhood cancers occur in developing countries, including countries in Sub-Saharan Africa. Malnutrition is a common problem among pediatric patients with cancer and ranges from 30% - to 80% globally. Weight loss is one of the most frequent and earliest symptoms in cancer patients, implying malnutrition. Malnutrition in paediatrics has negative consequences on the health of children. A chronic disease like cancer affects the nutrition of developing children either by the disease process itself or resulting from complications of treatments.
Objectives: This study aimed to describe nutritional status, feeding problems, and existing oral nutritional support for children with cancer who were admitted to the Pediatric Oncology Unit (MNH).
Methods: A hospital-based, prospective cohort study involving 246 patients was done at the Pediatric Oncology Unit (MNH). Patients with any malignancy were recruited in the study. Assessed nutrition status, feeding problems and nutritional support practices. Data was collected using Excel and analysed using R version 4.2.3.
Result: A total of 246 participants aged 0-19 Years met the inclusion criteria and were enrolled for the study on admission. Most recruits were males, accounting for about 55.7%, followed by females, accounting for 44.3%. On follow-ups, the frequencies of males were still high compared to females across follow-up points: after 4 weeks, after 8 weeks, and after 6 months. This study has revealed that 11.8% of the participants had SAM, 28.5% had MAM and about 59.3 % had normal nutrition. Almost half of the participants reported being malnourished on admission, either moderately malnourished or severely malnourished. Age group 0 - 5 Years contributes to high frequencies of malnourished children compared to other age groups from baseline across other follow-ups. This study revealed that the majority of children present at the hospital on admission with different types of feeding problems, which complicates further 4 weeks later after starting cancer therapy. Hospital meals are the most familiar nutritional support, accounting for more than 85%, followed by smoothies, special porridge, peanuts, and F75/100, the least used dietary interventions. Studies showed that a high percentage of patients receive nutrition education and advice from the point of admission to follow-ups throughout the treatment period.