Prevalence of wasting and associated factors among pediatric cancer patients aged 2-17 years at Uganda Cancer Institute.

Abstract

Introduction: Wasting is a major concern among pediatric cancer patients, significantly affecting treatment outcomes and quality of life. However, limited data exists on the prevalence of wasting and its associated factors at the Uganda Cancer Institute (UCI), hence the purpose of this study. Objective: to determine the prevalence of wasting and its associated factors among pediatric cancer patients aged 2 -17 years at UCI. Methods: An institutional-based, convergent mixed-methods study was conducted among 270 randomly selected caregiver-child pairs. 15 respondents were also purposively selected (11 IDIs and 4 KIIs) to participate in the study. Univariate, bivariate and multivariable analyses were computed using STATA SE.14. Variables with P-value < 0.05 at multivariable analysis were considered statistically significant. Qualitative data was thematically analyzed using ATLAS. ti Software version 6. Results: Among 270 pediatric cancer patients aged 2-17 years, 27.41% (n=74) were wasted. Children aged 5 years and older had a 17% higher prevalence of wasting (aPR=1.17; p=0.002). Cancers near the gastrointestinal tract were associated with an 11% higher prevalence (aPR=1.11; p=0.028). Caregivers with tertiary education reduced the wasting prevalence by 16% (aPR=0.84; p=0.002), while treatment effects increased the prevalence by 14% (aPR=1.14; p=0.013). Qualitatively, four themes—cancer-related factors, treatment effects, caregiver challenges, and healthcare provision challenges—were identified to influence wasting. Conclusion: wasting is a common modifiable malnutrition condition among pediatric cancer patients requiring integration of clinical management, policy revisions, public health interventions, and further research to overcome, and improve the children’s quality of life as well as survival.