Nutritional status and quality of life of paediatric cancer patients undergoing chemotherapy at Moi Teaching and referral hospital Eldoret, Kenya

Abstract

Malnutrition is a common problem among patients with cancer and ranges from 30% - 80% globally. In Kenya cancer ranks third as a cause of death after infectious diseases and cardiovascular diseases. The aim of this research was to assess the nutritional status, the prevalence of nutrition- impact symptoms (NIS) at each disease stage and determine the relationship between nutritional status and quality of life (QoL) of the 52 children suffering from cancer on chemotherapy at Moi Teaching and Referral Hospital (MTRH) Eldoret, Kenya. The research adopted across-sectional analytical design with which the interviewer administered the questionnaires to collect data on socio demographic, food consumption, nutrition management practices and the nutritional status from the respondents. Observational check list was also used to gather information on patient’s general appearance or any physical sign of malnutrition. Quality of life was assessed using Lansky scores while Nutritional Risk Screening (NRS-2002) was used to screen for any nutritional risk in the study population. Data was entered and analyzed using statistical package for social sciences (SPSS) version 21 and summarized using descriptive statistics such as frequencies, means and percentages. Anthropometric data was analyzed using WHO Anthro software (version 3.2.2) for children <5 years while WHO Anthro plus software (version 1.0.4) was used to analyze data for children above 5 years. Pearson correlation was done to test for the relationship between nutritional status and quality of life. A P value of < 0.05 was considered statistically significant. The study findings showed that 55.8% of the respondents were wasted, 34.6% stunted, while 29.4% were underweight. It was noted that 28.9% of the sample population were nutritionally at risk. Nutrition impact symptoms were more pronounced in the second and third stages of cancer where most of the respondents experienced vomiting (94.3%), decreased appetite (80.8%) and diarrhoea (69.2%). The study found a significant negative correlations between Quality of life and nutrition risk scores of the respondents (r = - 0.33, p = 0.02) at a significant level of (p < 0.05). QoL correlated positively with nutritional status based on Body Mass Index-for-age Z-scores (r = 0.41, p= 0.01) with a significant level of (p < 0.05). QoL was also found to positively correlate with Height-for-Age Z-scores, (r = 0.06, p = 0.72) though the correlations were not statistically significant (P > 0.05). It can therefore be concluded that chemotherapy was associated with poor nutritional status and reduction in the quality of life ratings. The use of the Nutrition Impact Symptom (NIS) checklist in the paediatric oncology clinic/ward triggers more therapeutic interventions. The awareness for NIS will likely evoke more research in assessment, impact, and treatment.