Magnitude of malnutrition and its associated factors among pediatric cancer patients on chemotherapy at oncology centers in Addis Ababa, Ethiopia, 2024.

Abstract

Malnutrition among children and adolescents with cancer in low- and middle income countries significantly contributes to several adverse outcomes which have an impact on health-related quality of life and overall survival. This study aimed to assess the magnitude of malnutrition and its associated factors among pediatric cancer patients on chemotherapy. A health institution-based cross-sectional study was conducted among pediatric cancer patients receiving chemotherapy aged from birth to 15 years attending at Black Lion specialized hospital and Saint Paul's millennium medical college from May 1 to July 1, 2024. By using a simple random sampling method, 345 participants were selected for face to face interview and anthropometric assessments. Pre-tested semi-structured questionnaire, chart review and anthropometric measurement were used. Variables with p-value <0.25 in the bi-variable logistic regression analysis were entered and checked for association in a multivariable logistic regression model. The level of statistical significance was declared at the p-value < 0.05. In this study, we successfully enrolled 320 pediatric cancer patients, which represents a response rate of 92.8% (320/345). The magnitude of malnutrition, defined by low BMI-for-age or weight-for-height/length z-scores, was 28.4% (91/320) (95% CI: 24.8%-31.3%). Additionally, the prevalence of stunting, based on height-for-age, was 30.6% (98/320) (95% CI: 26.5%-34.2%).Children in the age category of 11-15 years (AOR = 2.54, 95% CI; 1.18-5.48), Children's of mothers educational level illiterate, (AOR = 2.20, 95%CI; 1.01-4.75), Children form Households which earn <2000 ETB (AOR = 2.93, 95%CI; 1.14-7.53), Children with a cancer duration of 2-4 years (AOR = 1.34, 95%CI; 1.05-1.71), Children with hematologic malignancy (AOR = 2.18, 95%CI; 1.16-3.81), Children who had co-morbidities (AOR = 1.54, 95% CI; 1.12-2.10) and, Children's who have difficulty of swallowing (AOR = 2.11, 95%CI; 1.22-3.95) were significantly associated factors with being malnourished. This study identified malnutrition in 28.4% (91/320) of participants undergoing chemotherapy. Children most at risk were those between 11 and 15 years old, from low-income households, with mothers who had no formal education, Children with a cancer duration of 2-4 years, with hematologic malignancies, with co-morbidities, and with difficulty swallowing.