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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Acute malnutrition is common in Malawian patients with a Wilms tumour: A role for peanut butter
Pediatric Blood and Cancer, Volume 53, No. 7, Year 2009
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Description
Background. Children with cancer in resource limited countries are often malnourished at diagnosis. Acute malnutrition is associated with more infectious complications and an increased risk of morbidity and mortality in major surgery. Methods. All new patients with the clinical diagnosis of a Wilms tumour admitted in the Queen Elizabeth Central Hospital, Blantyre, Malawi from January 2007 until June 2008 were included. We documented anthropometric parameters, tumour size and serum levels of micronutrients at diagnosis. Corrected weight (body weight - tumour weight) was repeated after 4 weeks of preoperative chemotherapy. During therapy oral feeds were encouraged and a locally made ready to use therapeutic peanut butter-based food (chiponde) supplied. Results. A high rate of acute malnutrition was found in patients with Wilms tumour at diagnosis (45-55%), much higher than in community controls (11%). Patients (40%) and community controls (37%) had a similar, high rate of stunting (low height for age), a sign of chronic malnutrition. Tumour size at diagnosis and the degree of acute malnutrition at diagnosis was correlated; patients with a larger tumour had more severe acute malnutrition (r = -0.88, P < 0.01). With a supply of chiponde, 7 of 18 patients had a >5% increase in corrected weight during preoperative chemotherapy. Patients with a more positive nutritional course had a better tumour response to chemotherapy (r = 0.52, P < 0.05). Surprisingly, few micronutrient deficiencies were found, except for low serum levels of vitamin A (44% of patients). Conclusion. Acute malnutrition, superimposed on chronic malnutrition, is common in patients with Wilms tumour in Malawi. Earlier presentation needs to be encouraged. Chiponde, a peanut butter based ready-to-use-therapeutic-food, is an attractive means of nutritional support which needs further study. © 2009 Wiley-Liss, Inc.
Authors & Co-Authors
Israëls, Trijn
Malawi, Zomba
University of Malawi
Netherlands, Amsterdam
Emma Kinderziekenhuis
Borgstein, Eric S.
Malawi, Zomba
University of Malawi
Jamali, Monica
Malawi, Zomba
University of Malawi
De Kraker, Jan
Netherlands, Amsterdam
Emma Kinderziekenhuis
Caron, Huib N.
Netherlands, Amsterdam
Emma Kinderziekenhuis
Molyneux, Elizabeth M.
Malawi, Zomba
University of Malawi
Statistics
Citations: 50
Authors: 6
Affiliations: 2
Identifiers
Doi:
10.1002/pbc.22158
ISSN:
15455009
e-ISSN:
15455017
Research Areas
Cancer
Food Security
Health System And Policy
Maternal And Child Health
Study Locations
Malawi