Nutritional status and food consumption patterns of children with cancer: a case of Kenyatta National Hospital, Kenya

Abstract

Observations at the Kenyatta National Hospital wards prior to the indicated a marked increase in cases of child cancer patients and their various complications. These complications, which included vomiting, loss of appetite, wasting and anaemia interfered with food consumption patterns of children with cancer. Since cancer is a terminal disease, the medical treatment of most children is usually more emphasized than the nutritional management but the two complement each other. Less emphasis on diet therapy increases morbidity and infections since the immunity of these children is weakened and they are not able to fight the disease effectively. The purpose of this study therefore was to investigate the nutritional status and food consumption patterns of children with cancer at Kenyatta National Hospital. A descriptive survey design was used. The study targeted children between the ages 6 months to 14 years. The study sample was made up of 60 children. In addition the service providers consisted of 5 doctors, 5 nutritionists and 5 matrons who were interviewed to supplement data. Every second child was purposively selected from those attending clinics as well as those in the oncology ward and other wards with cancer children. Data collection instruments included a self administered questionnaire for the doctors, matrons and nutritionists, an interview schedule for the patients and another similar one for guardians in cases of children who were too young. Anthropometry, a 24 hour dietary recall and an observation checklist were also used. Data were organized and analysed both manually and by computer using the Statistical Package for Social Sciences (SPSS) Programme, yielding descriptive statistics. Research findings revealed that 32% of the children were stunted, 26% were underweight while 12% were wasted. The findings confirmed that all the 18.3% children in the advanced stage of the disease were malnourished. A majority (88.5%) of the children's food intake was affected by the type of treatment received while the disease process affected 71.8% of the patient's food intake. Most of these interferences occurred in the middle (55%) and advanced stages (18.3%) of the disease. Therefore as treatment becomes more vigorous and as the disease advances the patients tend to develop more nutritional problems since their food intake is affected. From the findings of this study, it is concluded that food consumption patterns of children with cancer at Kenyatta National Hospital were influenced by the following factors: type of cancer a child suffered from, stage of the disease, duration of cancer disease and therapy used to manage their conditions. In view of these findings, the study recommends that nutritionists should emphasize the importance of adherence to the amounts of nutrients recommended for individual child cancer patients