Impact of Nutrition Screening for Prediatric Oncology Patients at Bugando Medical Centre, Mwanza Tanzania

Abstract

PURPOSE Malnutrition is a common and serious issue among pediatric oncology patients in low and middle 299income countries. Early identification of patients at high nutritional risk through screening can improve clinical outcomes including reduced treatment toxicity, reduced risk of developing infections and improved quality of life. This study investigates the impact of implementing a nutrition screening and tailored nutritional supplementation for pediatric oncology patients at Bugando Medical Centre (BMC), in Mwanza, Tanzania. METHODS A prospective study was conducted from October 2021- March 2023 for all pediatric oncology patients (<18yo) who attended clinic at Bugando Medical Centre. A trained nutritionist evaluated patients prior to each clinic visit and at regular intervals during their hospital stays. In addition to demographic and diagnostic information, the screening included assessment of nutritional status with tailored dietary support with ready-to-use therapeutic food (ie. plumpy nut) and F75/F100 therapeutic milk formula. All patients received nutritional porridge at each clinic encounter. RESULTS A total of 312 patients were screened, with 40% were female(n=125). With an average age of 7.3, and the most common diagnoses were Wilms tumor, Retinoblastoma, ALL and Non-Hodgkin's Lymphoma. 38% (n=119) of patients screened had malnutrition, with 45% (n=54) having severe malnutrition (SAM). Patients with hematological malignancies had more overall malnutrition compared to solid tumors (45% vs 34%). Among malnourished patients who received at least 1 month of nutrition directed therapy (n=71), 62% (n=44) improved their nutritional status and 48% (n=34) achieved normal nutritional status. CONCLUSION Nutritional screening is an important part of comprehensive cancer care for children in low and middle income countries but is not universally implemented. The majority of patients at BMC were found to be malnourished at diagnosis, but with tailored therapy, were able to improve and even normalize their nutritional status. Future research is needed to evaluate the impact of this improved nutrition on chemotherapy toxicity and patient outcomes.