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19 June 2023 | Story André Damons | Photo André Damons
Prof Jan Du Plessis
Prof Jan du Plessis is Head of the Paediatric Oncology Unit at the University of the Free State.

Many children in South Africa diagnosed with childhood cancer have a poorer overall survival rate and are more likely to abandon their treatment because they experience high poverty and food insecurity at home.

This is according to findings from a new study which Prof Jan du Plessis, Head of the Paediatric Oncology Unit at the University of the Free State (UFS), was part of. The study, titled ‘Prevalence of Poverty and Hunger at Cancer Diagnosis and Its Association with Malnutrition and Overall Survival in South Africa’, was recently published in the journal Nutrition and Cancer.

It found a high prevalence of poverty and hunger among South African children diagnosed with cancer. Food insecurity was associated with treatment abandonment and poorer overall survival.

The research was conceptualised by Judy Schoeman, dietitian at the Steve Biko Academic Hospital, as part of her PhD study. Prof Du Plessis and departmental dietitian Mariechen Herholdt, who recognised the importance and value of this study, enrolled patients, collected data, and critically reviewed the manuscript. Five different paediatric oncology units throughout the country participated.

Stunting as indicator of chronic malnutrition

Prof Du Plessis says stunting is an indicator of chronic malnutrition, and causes tissue damage, reduced function of neurotransmitters, and decreased overall development of all factors. Stunting is also associated with reduced lung growth and -function, which can influence the prevalence of pulmonary infections, have an impact on morbidity, and increase the risk of mortality. It also affects cognitive development, with poorer academic achievement and reduced economic productivity for children and adults affected by stunting.

“Our study found that South African children with malnutrition at cancer diagnosis often experienced food insecurity at home, underscoring the need to address primary rather than secondary malnutrition. This observation was especially apparent among children from rural provinces,” Prof Du Plessis says. “Many children in our study experienced high poverty and food insecurity risk at diagnosis; thus, nutritional counselling targeting dietary intake in the home setting should be a priority for these patients.”

High-quality diet may have protective effect

Recent literature has found that a high-quality diet may have a protective effect against some treatment-related toxicities of cancer treatment. Hunger at home was significantly associated with increased risk for treatment abandonment and risk of death.

Prof Du Plessis states, “According to the South African census (2015), 30 million people live on less than R84.11 (US$5) per day, and 55% of South African children live below the ultra-poverty line (R800/month or US$45.81/month)…

“In a previous South African study of children with germ cell tumours from families with higher socioeconomic status (household income of US$191/year or US$6/day), they have experienced significantly improved overall survival (OS) at five years. Indonesian children from low-income families diagnosed with acute lymphoblastic leukaemia have also experienced significantly lower event-free survival two years or longer after diagnosis than those from higher-income families.”

Prof Du Plessis says nutritional intervention should be implemented from diagnosis to improve patients’ nutritional status and survival.

Enhance collaborations to enhance outcomes

The study further illustrated that children with stunting and malnutrition at cancer diagnosis were more likely to live in poverty, thereby highlighting a group of children needing social services and support networks over and above the existing structures available to South African children with cancer.

The study underscores the need for medical centres to enhance collaboration with organisations that provide financial and/or other support to families throughout treatment to enhance outcomes.

The study came about as poor nutritional status in children with cancer has been associated with poorer cancer outcomes. Identifying modifiable risk factors that lead to poor nutrition in children with cancer is an understudied area, especially in a country such as South Africa, explains Prof Du Plessis. 

“Understanding the scope of poverty and hunger and its association with nutritional status among children undergoing cancer treatment is needed. As half of South Africans experience chronic poverty over time, food insecurity will be affected; we investigated the prevalence of poverty and food insecurity at cancer diagnosis, their association with malnutrition at the time of diagnosis, and overall survival at one year post-diagnosis.

“Malnutrition is a modifiable prognostic risk factor. The findings underscore the importance of incorporating an assessment of the risk of living in poverty and/or with food insecurity at diagnosis – and potentially throughout therapy – to ensure that families are referred to appropriate support networks. Evaluating sociodemographic factors at diagnosis is essential among South African children to identify at-risk children and implement adequate nutritional support during cancer treatment,” Prof Du Plessis concludes.

This research aligns with the UFS’s Vision 130 – to not only be a university that cares and is sustainable, but also to be a research-led, student-centred, and regionally engaged university that contributes to development and social justice. This knowledge will assist in efficiently allocating hospital resources and establishing support networks to ensure that the most vulnerable children are supported with proactive nutrition interventions while undergoing cancer treatment.

News Archive

UFS research project aims to stimulate reflection on theological studies
2017-06-20

Description: Book, Theology and post Apartheid condition  Tags: Book, Theology and post Apartheid condition

The first book in the ‘UFS Theological
Exploration’ academic series, called Theology
and the Post(Apartheid) Condition
, has just
been released.
Photo: Supplied

 

The first study book with the title Theology and the Post(Apartheid) Condition, which is part of a new academic series by the Faculty of Theology and Religion at the University of the Free State, is now available. Volume 1, compiled by Professor Rian Venter as editor, is the first book in the ‘UFS Theological Exploration’ academic series, which the faculty plans to release.

Transformation
Professor Venter says the transformation of processes and practices in communicating and creating knowledge has become an urgent task for public universities in a democratic South Africa. Much reflection has already gone into the methods and scope of transformation in higher education.

Although the faculty has done work on the implications of this for theology, there is one area of investigation that has not received much attention. It concerns the role of theological disciplines such as Old and New Testament, Missiology and Systematic Theology and Practical Theology, and specifically the relationship between academic disciplines and societal growth. The book focuses on these challenges and contains the intellectual undertakings of the contributors who are all lecturers, research fellows and post-graduate students linked to the faculty.

The questions
The key questions addressed are: what are the contours of the (post)apartheid condition and what are the implications for responsible discipline practices in theology. Professor Venter says the chapters in the book are logically arranged and moves from wider to more specific concerns. The first three chapters suggest broad perspectives on the challenges for theology in higher education, chart the changes, and make some suggestions for the future.

A dynamic field of study
The book states that theology has already experienced profound and radical changes over the past decade, which is known to us. All the chapters demonstrate these fundamental shifts, which have taken place in all theological sub-disciplines. Professor Venter says the contributions in the book illustrate that theology is a dynamic field of study, and is pursued with enthusiasm and commitment. Not all disciplines in theology are investigated for the book. However, the studies reflect the interests of the theologians in the Faculty of Theology at the UFS. Professor Venter hopes that the volume might stimulate further reflection of a similar nature by other theologians.

New insights
Through the ‘UFS Theological Exploration’ research series, the faculty hopes to stimulate new insights and new developments in academic progress and overall human growth. Series editor Professor Francois Tolmie says it is a fact that strong university research is necessary to achieve academic progress and advance human prospering. He says the faculty's research series will make a valuable contribution to these causes. Professor Tolmie says the ‘UFS Theological Explorations’ contains research of the highest academic standard which has been peer-reviewed to make significant educational contributions to core theological issues in South Africa and overseas.

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