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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

Two honorary doctorates part of highlights at UFS graduations
2017-11-30


  Description: Dec gradspeakers Tags: Graduation Ceremonies, Prof Paul Holloway, Marius Botha, Joyene Isaacs, Likeleli Monyamane, Leah Molatseli, Dr Imtiaz Sooliman

  Leah Molatseli (left), Dr Imtiaz Sooliman, and Likeleli Monyamane will be
  the guest speakers during the End-of-year Graduation Ceremonies
  at the University of the Free State.
  Photos: Supplied, www.mudboots.co.za

Roads and entrance closed due to roadworks on the Bloemfontein Campus

Graduation Livestream

Two honorary doctorates and a Chancellor’s medal will be some of the highlights during the End-of-year Graduation Ceremonies at the University of the Free State (UFS).

The Callie Human Centre on the Bloemfontein Campus will once again welcome graduates, their parents, friends, and relatives for the celebrations on 6 and 7 December 2017. A total number of 1226 qualifications, including diplomas, certificates, and degrees, will be conferred during the two days.

Altogether 40 doctorates and 109 master’s degrees will be awarded. Most doctorates (19) will be awarded in the Faculty of Natural and Agricultural Sciences, while most of the master’s degrees (27) are in the same faculty.

Prof Holloway, Botha, and Isaacs honoured
Prof Paul Holloway (Natural and Agricultural Sciences) and Marius Botha (Law) will receive honorary doctorates during the afternoon ceremony on 7 December 2017, while Joyene Isaacs (Natural and Agricultural Sciences) will be honoured with a Chancellor’s Medal.

Prof Holloway is an internationally acclaimed expert in the science and technology of surfaces, thin films, and nanoparticles, and Botha has played a significant role in financial planning in South Africa. Isaacs is the Head of Department of the Western Cape Department of Agriculture, and her department has been nominated by the South African Institute of Government Auditors as the best government department. 

Young leader, young alumnus, and humanitarian

Likeleli Monyamane, Leah Molatseli, and Dr Imtiaz Sooliman will be the guest speakers at the ceremonies.

Monyamane, a UFS Council member, will address graduates on 6 December 2017 during the morning ceremony. She is one of 15 young leaders selected to represent Lesotho as participants in the Mandela Washington Fellowship in the United States. In 2016, Molatseli, the speaker during the afternoon session on 6 December 2017, launched South Africa’s first legal ecommerce website, Lenoma Legal, and is the university’s most recent Young Alumnus of the Year.

Dr Sooliman, the speaker at both ceremonies on 7 December 2017, is the founder and Director of the Gift of the Givers Foundation. He has received more than 100 national and international awards, citations, commendations, and special recognition for his humanitarian work.

Date: 6 December 2017
Time: 09:00: All qualifications up to Honours degrees in the Faculty of Economic and Management Sciences (including the Business School) and the Faculty of Natural and Agricultural Sciences
14:30: All qualifications up to Honours degrees in the Faculties of Education, Law, the Humanities, and Theology

Date: 7 December 2017

Time: 09:00: All qualifications up to Honours degrees in the Faculty of Health Sciences and Educational qualifications in Open Distance Learning – South Campus
14:30: Master’s and Doctoral degrees in all faculties

For information about the ceremonies, click here to visit the graduation home page.

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