Short-term chemotherapy-related complications and undernutrition in children diagnosed with cancer at Korle Bu Teaching Hospital, Accra, Ghana
Description
This was a hospital-based, prospective, observational cohort study at the Paediatric Oncology Unit (POU), Korle Bu Teaching Hospital (KBTH), Accra, Ghana. Children below 12 years of age were included in the study. Participants were recruited at diagnosis of cancer and followed up for 12 weeks from the start of initial chemotherapy. Recruitment was from 4th January, 2019 to 25th December 2019, and the last follow up visit was on 18th March 2020. At cancer diagnosis, data obtained included demographic, socioeconomic, type and stage of cancer and anthropometric measurements -weight, height, mid-upper arm circumference were collected. The weight-for-age (WFA), height/length-for-age (HFA), weight-for-height/length (WFH) and body mass index (BMI) were derived and categorized based on data from the World Health Organization (WHO) anthro/anthroplus software and categorized based on the World Health Organization. The upper arm muscle area (UAMA) was calculated using the formular embedded in excel and categorized based on the Mramba criteria. For patients who were grossly oedematous, weight measurements were delayed until clinical resolution of oedema. Acute events like diarrhoea and vomiting that could contribute to acute weight loss were documented. Solid tumours and lymphomas were staged and leukaemias were risk-stratified. Together, all cancers were re-classified into standard risk and high risk. Solid tumours and lymphomas were re-classified as high risk if they were at least stage 3 while the leukaemias maintained the terminology of standard and high risks categories. During follow-up patients who developed any of the selected chemotherapy-related complications and deaths were documented. The 12-week follow-up period was calculated from the start of chemotherapy. Study participants who developed any of the five selected chemotherapy-related complications: anaemia requiring red blood cell transfusion; thrombocytopenia requiring platelet transfusion or resulting in delay of scheduled administration of chemotherapy or both; febrile neutropenia; neutropenia resulting in delay of administration of scheduled chemotherapy and mucositis. The time each participated lasted in the study was also documented to account for treatment abandonment and death