Nutritional status and barriers to optimal nutrition among pediatric patients with cancer in tanzania: a quantitative analysis.

BACKGROUND

Childhood cancer is a growing public health concern in low- and middle-income countries (LMICs), where over two-thirds of global pediatric cancer cases occur. Despite advances in diagnosis and treatment, malnutrition remains a major barrier to achieving better outcomes. This study aimed to assess the magnitude of undernutrition and identify barriers to optimal nutrition among pediatric patients with cancer receiving treatment at a major referral hospital in Tanzania.

METHODS

Two study populations were recruited: pediatric patients with cancer and their primary caregivers. Children were assessed for undernutrition using anthropometric indicators, including mid-upper arm circumference, weight-for-age, height-for-age, body mass index-for-age Z-score, and triceps skinfold thickness. Nutritional biomarkers, including serum albumin, total protein, hemoglobin, and mean corpuscular volume, were also evaluated. Caregivers completed structured questionnaires adapted from the Hunger Vital Sign™ and the United Nations Food and Agriculture Organization Nutrition-related Knowledge, Attitude, and Practices Questionnaire to assess the risk of food insecurity and caregiver nutrition knowledge and perceptions. Binary logistic regression was used to explore predictors of undernutrition.

RESULTS

A total of 65 pediatric patients were enrolled, of whom 41.54% were classified as undernourished based on at least one anthropometric indicator below age-specific thresholds. Although 44.62% had low serum albumin and 30.77% had low total protein, these biomarkers may reflect overall illness rather than nutritional deficiency alone. Anemia was observed in 53.85% of children under 5 and 38.46% of those aged 5 and older. Logistic regression showed that undernutrition was more likely among children aged 5-10 and > 10 years compared to those < 5 years (OR: 1.80; 95% CI: 0.88-3.68; p = 0.109), while anemia showed an inverse and unexpected association (OR: 0.15; 95% CI: 0.02-1.44; p = 0.100); however, neither was statistically significant. The risk of food insecurity was identified in 78.4% of households. Caregivers not at risk demonstrated significantly better nutrition knowledge and more positive perceptions than those at risk.

CONCLUSION

Undernutrition is common among pediatric patients with cancer and may be influenced by clinical and socioeconomic factors, including anemia, caregiver knowledge, and household food insecurity.

TRIAL REGISTRATION

This study is not a clinical trial and does not require registration.

CLINICAL TRIAL NUMBER

not applicable.