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<p>Background: Nutrition is a key determinant of pediatric cancer patient outcomes
in sub-Saharan Africa. Accurately identifying pediatric cancer patients at risk of
malnutrition remains a challenge. There is a need for a standardized nutritional screening
tool, developed and validated in sub-Saharan Africa. Study aims: The aims of this
study were to: 1) select candidate variables in the development of a nutritional screening
from predictors associated with malnutrition in pediatric cancer patients and, 2)
conduct a secondary data analysis estimating the prevalence of pediatric cancer in
Uganda from cases presented at the Uganda Cancer Institute between January 1, 2017
and December 31, 2019. Methods: This study is a longitudinal hospital-based study,
carried out at the Bugando Medical Center in Tanzania and Uganda Cancer Institute
in Uganda. The study enrolled clinically confirmed pediatric cancer patients (<18
years) at the study sites. Measures of interest include: nutritional status, symptom
duration, abdominal distention, anthropometric measures such as height, weight, mid-upper
arm circumference, abdominal circumference, triceps skinfold thickness, and clinical
characteristics such as serum albumin, mean corpuscular volume, and protein. Logistic
regression models examined predictors of nutritional status in pediatric cancer patients.
Lastly, geospatial analysis estimated the prevalence and examined the country-wide
distribution of the pediatric cancers presented at the Uganda Cancer Institute between
2017 and 2019. Results: The sample of 77 pediatric cancer patients enrolled at the
two study sites ranged from 1 to 17 years old. Solid tumor malignancies like Wilms
tumor comprise of 40% of all diagnoses. 60% of cancer patients were malnourished at
baseline. The strongest predictors of nutritional status were mid-upper arm circumference
(AOR 0.52, 95% CI: 0.31 – 0.87), abdominal circumference (AOR 1.38, 95% CI: 1.16 –
1.65) and serum albumin (AOR 0.73, 95% CI: 0.62 - 0.86). Secondary analysis of the
Uganda Cancer Institute registry shows 11607 patients with confirmed cancer diagnosis
between 2017 and 2019. Acute lymphoblastic leukemia (31.4%) is the most common cancer
diagnosis, followed by Wilms tumor (19.1%), rhabdomyosarcoma (9.4%) and Burkitt’s
lymphoma (6.9%). Blood cancers are most common cancer types, of them the most frequent
cases being leukemia (37%). 2018 saw the highest number of cancer presentations within
the study timeframe. Conclusions: The results show abdominal circumference, serum
albumin, and muac are candidate variables in developing a nutritional screening tool
for pediatric cancer patients in SSA. Blood and solid cancers are prevalent in Uganda;
thus, a customized nutritional screening tool is much needed.</p>
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