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

Childhood cancers such as Burkitt’s lymphoma (BL) aTumour (WT) are common in Africa. In Ghana , the nutritional status of children with cancers is larg ely 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 wi th 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 us ing 3-day repeated 24-hour dietary recalls, anthropometrics, physical and clinical signs of malnutrition, and bi ochemical indicators. With the exception of height, the cance r children had significantly lower weight (18.7 ver sus 27.4 kg), Mid Upper Arm Circumference (MUAC) (14.1 versus 17. 8 cm), Triceps skinfold (TSF)(4.9 versus 6.1 cm), M uscle Arm Circumference (MAC) (12.4 versus 1.8 cm) and Bo dy Mass Index (BMI) (14.6 versus 18.4 kg/m 2 ), and higher levelsof malnutrition by all indicators: wasting=31 %, underweight=34% and stunting=51%) compared to th e noncancer controls (wasting=8%, underweight=7% and stu nting=43%).Among the cancer children 40% showed physical signs of wasting, 15% oedematous and 40% l ow haemoglobin (Hb). Food and nutrients intake were similar between the two groups.The cancer group had signifi cantly lower levelsof glutathione (p=0.003) and pre albumin (p< 0.0001) than their non-cancer counterparts. The best biochemical and anthropometric predictors for malnutrition were Hb and MAC respectively. The find ings suggest a high prevalence of malnutrition amon g childhood cancer sufferers and that the traditional nutritional indicators are able toaccurately predi ct malnutrition among cancer children in resource limited settings.