A J Murphy1, T T Mosby2, P C Rogers3, J Cohen4, E J Ladas5. 1. Children's Nutrition Research Centre, Queensland Children's Medical Research Institute, The University of Queensland, Brisbane, Queensland, Australia. 2. Clinical Nutrition Services, St Jude Children's Research Hospital, Memphis, TN, USA. 3. Division of Pediatric Hematology/Oncology/Bone Marrow Transplant, British Columbia Children's Hospital, Vancouver, British Columbia, Canada. 4. Kids Cancer Centre, Sydney Children's Hospital, Sydney, Australia. 5. 1] Division of Pediatric Hematology/Oncology/Stem Cell Transplant, Columbia University, New York, NY, USA [2] Institute of Human Nutrition, Columbia University, New York, NY, USA.
Abstract
BACKGROUND/ OBJECTIVES: Optimal nutritional status is important in children with cancer, as it can influence clinical outcomes. To improve the nutritional health of children and adolescents receiving treatment for cancer residing in low income and middle-income countries (LMIC), we investigated nutrition practices among these nations' institutions providing treatment for childhood cancer. SUBJECT/ METHODS: A cross-sectional survey of nutrition practice was administered to staff members at institutions providing treatment for children with cancer between 2011 and 2012. Countries classified as low income and middle income were divided by geographical region. Final analysis was performed with 96 surveys, which included 27 institutions from Asia, 27 institutions from Latin America and Caribbean, 27 institutions from Africa and 15 institutions from Europe. RESULTS: The study found that 55% of institutions had a dietician available on their service. Access to dieticians, lack of nutrition resources and lack of nutrition education of staff were the main barriers to providing nutrition care in LMIC. Half of the institutions performed nutritional assessment at diagnosis, and the methods used varied widely. Twenty-nine percent of all institutions used complementary and alternate therapies within their clinical practice, and 35% of institutions reported that nutrition education was provided to patients and families. CONCLUSIONS: Priority areas for improving the nutritional management in LMIC include the following: (1) improved nutrition education and assessment tools for doctors and nurses; (2) increased availability of nutrition education resources for families and patients; and (3) identification of the role of complementary and alternative therapies in closing gaps in symptom management in these institutions.
BACKGROUND/ OBJECTIVES: Optimal nutritional status is important in children with cancer, as it can influence clinical outcomes. To improve the nutritional health of children and adolescents receiving treatment for cancer residing in low income and middle-income countries (LMIC), we investigated nutrition practices among these nations' institutions providing treatment for childhood cancer. SUBJECT/ METHODS: A cross-sectional survey of nutrition practice was administered to staff members at institutions providing treatment for children with cancer between 2011 and 2012. Countries classified as low income and middle income were divided by geographical region. Final analysis was performed with 96 surveys, which included 27 institutions from Asia, 27 institutions from Latin America and Caribbean, 27 institutions from Africa and 15 institutions from Europe. RESULTS: The study found that 55% of institutions had a dietician available on their service. Access to dieticians, lack of nutrition resources and lack of nutrition education of staff were the main barriers to providing nutrition care in LMIC. Half of the institutions performed nutritional assessment at diagnosis, and the methods used varied widely. Twenty-nine percent of all institutions used complementary and alternate therapies within their clinical practice, and 35% of institutions reported that nutrition education was provided to patients and families. CONCLUSIONS: Priority areas for improving the nutritional management in LMIC include the following: (1) improved nutrition education and assessment tools for doctors and nurses; (2) increased availability of nutrition education resources for families and patients; and (3) identification of the role of complementary and alternative therapies in closing gaps in symptom management in these institutions.
Authors: Elena J Ladas; Terezie Tolar Mosby; Alexia J Murphy; Jennifer Cohen; Ronald Barr; Paul Rogers Journal: Pediatr Blood Cancer Date: 2012-06 Impact factor: 3.167
Authors: Alessandra Sala; Emanuela Rossi; Federico Antillon; Ana Lucia Molina; Tania de Maselli; Miguel Bonilla; Angelica Hernandez; Roberta Ortiz; Carlos Pacheco; Rosa Nieves; Marta Navarrete; Max Barrantes; Paul Pencharz; Maria Grazia Valsecchi; Ronald Barr Journal: Eur J Cancer Date: 2011-07-05 Impact factor: 9.162
Authors: Trijn Israels; Lorna Renner; Marc Hendricks; Peter Hesseling; Scott Howard; Elizabeth Molyneux Journal: Pediatr Blood Cancer Date: 2013-02-25 Impact factor: 3.167
Authors: Mercedes de Onis; Adelheid W Onyango; Elaine Borghi; Amani Siyam; Chizuru Nishida; Jonathan Siekmann Journal: Bull World Health Organ Date: 2007-09 Impact factor: 9.408