European Journal of Experimental Biology Open Access

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The assessment and prediction of malnutrition in children suffering from cancer in Ghana

Charles Apprey, Reginald A. Annan, Fareed K. N. Arthur, Samuel K. Boateng and Janet Animah

Childhood cancers such as Burkitt’s lymphoma (BL) and Wilms Tumour (WT) are common in Africa. In Ghana, the nutritional status of children with cancers is largely unknown although for most cancers, each step of the continuum from diagnosis to recovery, including chemotherapy, poses nutritional challenges. The study compared thenutritional status of sixty-four children: 32 with BL or WT at a major teaching hospital and 32 age- and sexmatched non-cancer controls in a nearby community, anddetermined the best predictor of malnutrition using 3-day repeated 24-hour dietary recalls, anthropometrics, physical and clinical signs of malnutrition, and biochemical indicators. With the exception of height, the cancer children had significantly lower weight (18.7 versus 27.4 kg), Mid Upper Arm Circumference (MUAC) (14.1 versus 17.8 cm), Triceps skinfold (TSF)(4.9 versus 6.1 cm), Muscle Arm Circumference (MAC) (12.4 versus 1.8 cm) and Body Mass Index (BMI) (14.6 versus 18.4 kg/m2), and higher levelsof malnutrition by all indicators: wasting=31%, underweight=34% and stunting=51%) compared to the noncancer controls (wasting=8%, underweight=7% and stunting=43%).Among the cancer children 40% showed physical signs of wasting, 15% oedematous and 40% low haemoglobin (Hb). Food and nutrients intake were similar between the two groups.The cancer group had significantly lower levelsof glutathione (p=0.003) and prealbumin (p< 0.0001) than their non-cancer counterparts. The best biochemical and anthropometric predictors for malnutrition were Hb and MAC respectively. The findings suggest a high prevalence of malnutrition among childhood cancer sufferers and that the traditional nutritional indicators are able toaccurately predict malnutrition among cancer children in resource limited settings.