Nutritional care practice status in Pediatric oncology units in low-and middle-income countries (LMICs): A Scoping Review

Abstract

Malnutrition is pervasive among pediatric cancer patients in low- and middle-income countries (LMICs). The survival rate of this population is far lower in LMICs than in high-income country (HICs), which in part is related to poor standardized nutritional care. However, the status of nutritional care for pediatric cancer patients, in LMICs remains poorly documented. The Preferred Reporting Item for Systematic Review and Meta-Analysis extension for Scoping Reviews (PRISMA-ScR) was used for reporting the evidences. Only studies conducted in LMICs and published in English were included. PubMed, CINAHL/EBSCOhost, ProQuest, Scopus and Google Scholar databases were searched to locate articles containing nutrition care or nutrition support for pediatric cancer patients in LMICs. Out of 457 articles, nine articles were considered in this scoping review. The evidence synthesis showed that nutritional care practice and research were reported only from limited pediatric oncology units (POUs) in LMICs .It was found that the provision of optimal nutritional care, including the SIOP-PODC algorithm through the support of local humanitarian and international collaborations like twinning partnerships, had significantly improved both the nutritional status and survival of those patients in LMICs. The coverage of nutritional care for pediatric cancer patients and research on the relationship between nutritional care and survival rates in those patients is limited to a few POUs in LMICs. This necessitates the implementation of the SIOP-PODC algorithm in large-scale longitudinal and experimental studies across more POUs, while carefully documenting its impact on the survival and other clinical outcomes of pediatric cancer patients in LIMICs. The resultant benefit of scaling up such care will be achieving the global target of increasing the childhood cancer patients’ survival rate in LMICs to 60% by 2030 and closing the gap in the survival rate between LMICs and HICs.