Nutritional Therapy in Malnourished Children With Cancer: Response Among Hospitalized Children in Northern Tanzania
Mary C. Chipanta, Aisa Shayo, Emanuel A. Nkya, Irene Lyatuu, Joshua S. Mollel, Rina R. Seni, Stella Shirima, Sarah Laway, Baraka Moshi, Esther MajaliwaBackground
Malnutrition significantly compromises treatment tolerance and outcomes in children with cancer. Although nutritional therapy has been incorporated into pediatric oncology care, its effectiveness remains unevaluated. This study assessed the effectiveness of nutritional therapy and predictors of poor response among malnourished children diagnosed with cancer in Northern Tanzania.
Methodology
A retrospective cohort study was conducted among children aged 6 months to 18 years diagnosed with cancer from January 2023 to December 2024 at a zonal referral hospital in Northern Tanzania. Children receiving palliative care were excluded. Nutritional therapy was initiated among children with acute malnutrition. At 6 months, nutritional response was determined by comparing changes in mean WHO z-scores and by assessing differences across cancer types using the independent t-test. A good response to therapy was defined as a WHO z-score > -2 SD at six months, while a poor response was defined as a WHO z-score ≤ -2 SD.
Results
Of 190 children diagnosed with cancer, 117 had acute malnutrition. Among these, 77 completed six months of follow-up, 37 died, and 3 were referred out. Nutritional therapy significantly improved mean WHO z-scores by 2.347 (p<0.001). Predictors of poor response included age below five years (AHR: 1.99, 95% CI: 1.05–5.46), combined chemotherapy and surgery (AHR: 1.22, 95% CI: 1.09–1.99), and neuroblastoma diagnosis (AHR: 1.47, 95% CI: 1.10–2.43).
Conclusion
Nutritional therapy significantly improved the nutritional status of malnourished children with cancer. Better response was observed among children older than five years, while poor response was associated with solid tumors and combined chemotherapy with surgery.