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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 offers bursaries for interpreters
2005-12-01

The Unit for Language Management (previously Unit for Language Facilitation and Empowerment) at the University of the Free State (UFS) is offering bursaries to persons who want to apply for the Post-graduate Diploma in Language Practice (interpreting) for 2006. 

The Unit was involved in the setting up of a comprehensive interpreting infrastructure at the Free State Legislature and provided the interpreting services for the Truth and Reconciliation Commission (TRC) for the latter’s full duration.

“The UFS supports a multilingual society.  Our language policy, which was approved by the Council in 2003, is a striking example.  This policy is in accordance with the national movement towards multilingualism and the recognition of language rights.  Through the training of interpreters the UFS is empowering others to exercise their language rights and to partake meaningfully in formal conversations,“ said Prof Theo du Plessis, head of the UFS Unit for Language Management (ULM). 

“The UFS has been using interpreter services at executive management meetings and other occasions such as meetings, seminars and conferences for several years.  The demand for these services has risen quite considerably.  We have found that the current three interpreters on the Main Campus will soon not be able to cope with this demand,” said Prof du Plessis.

According to Prof du Plessis institutions like the Mangaung Local Municipality and the Motheo District Municipality use the interpreter services of the ULM on a regular basis. 
“Because the demand for interpreter services is becoming so great, the demand for trained interpreters is also increasing.  This is why we are offering bursaries for persons who want to be trained as interpreters to register in 2006 for the Post-graduate Diploma in Language Practice (interpreting) as offered by the UFS Department of Afro-asiatic Studies and Language Practice and Sign Language,” said Prof du Plessis.

According to Prof du Plessis the UFS will be able to use these students on an ad-hoc basis to assist with interpreter services on the Main Campus or to deliver interpreter services to institutions outside the UFS. 

The bursaries will preferably be awarded to persons with English as mother tongue with an above average knowledge of Afrikaans or Sesotho.  The duration of the bursaries is one year and only tuition fees will be paid.  “To qualify for the bursaries, prospective students must have an undergraduate qualification,” said Prof du Plessis.

The closing date for applications is 25 January 2006.  For any enquiries, Mrs Susan Lombaard can be contacted at (051) 401-2405 or 072 605 4966 during office hours or at lombasc.hum@mail.uovs.ac.za.

Media release
Issued by: Lacea Loader
Media Representative
Tel:  (051) 401-2584
Cell:  083 645 2454
E-mail:  loaderl.stg@mail.uovs.ac.za
1 December 2005
 

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