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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

Access to the Bloemfontein Campus
2015-04-02

Access Control Made Easy

The first phase of access control at the University of the Free State (UFS) was implemented in August 2014. The aim of this initiative is to tighten security measures on the Bloemfontein Campus.
 
Since November 2014, access control has been implemented at all five gates on the Bloemfontein Campus. These are:

  • The Main gate in Nelson Mandela Drive (Gate 1)
  • The gate in DF Malherbe Drive (Gate 5)
  • The gate in Wynand Mouton Drive (Gate 3) 
  • The gate in Furstenburg Street (Gate 4)
  • The gate in Badenhorst Street (Gate 2)

Here is some useful information about the access control system:

1. Remember your access card when you enter the campus

Dual-function cards (with distance reader compatibility) will make your movement through the gates more convenient. The university’s access system works automatically with remote or swipe action. Please make sure that you drive close to the reader or, better still, get the dual-frequency card to manage the distance between your vehicle and the remote card reader.

As of 23 March 2015, the extra security staff, who have been assisting at the gates since the implementation of access control on the Bloemfontein Campus, are no longer manning the card readers at the gates. Therefore, persons without cards will be able to enter the campus only at the one gate in DF Malherbe Drive where the Visitors Centre is situated. They will be referred to the Visitors Centre, where a day visitor’s card will be issued to them. You will need to produce a formal identification document (e.g. ID book, driver's licence).

Security will continue their normal duties at the guardhouses for the various gates on the campus.

2. Where do I get an access card?

You can apply at the university’s Visitors Centre front desk by producing your positive identification (ID book/passport/driver’s licence) and proof of payment for your access card.

You will then be directed to the Thakaneng Bridge where you will be able to collect your access card.

  • Go to the Cashier on the Thakaneng Bridge and pay your R65 for the dual-frequency card
  • Take your receipt, together with your existing card (if you have one), to the Card Division on the Thakaneng Bridge (next to Mellins Optometrists)
  • A new photo will be taken of you at the Card Office for your new card. Your new card will then be issued immediately.

Currently, there is a sufficient stock of the dual-frequency cards available at the Card Division on the Thakaneng Bridge.
 
Alternatively, you can apply online for your access card: http://apps.ufs.ac.za/cardapplication/application.aspx

Make sure you have the following documents ready to attach when completing the online form:

  • Copy of positive identification: ID/Driver's Licence/Passport
  • Signed declaration (http://supportservices.ufs.ac.za/dl/Userfiles/Documents/00007/4668_eng.pdf) by your service provider/employer (if you are a service provider) or a letter of confirmation from your spouse/partner/relative/coach/relevant UFS staff member or student in cases where you have to visit, pick-up or drop off your spouse/partner/relative frequently on the UFS Bloemfontein Campus.

Cost: R65 for a long-term card and free of charge for short-term visits and conference delegates. Pay at the Cashier on the Thakaneng Bridge or at Absa Bank, Account Number: 1 570 8500 71, Ref: 1 413 07670 0198.

3. Cutoff Date: 7 April 2015

After 7 April 2015, no pedestrian or motorist will be able to enter the campus without a valid access card. Persons without access cards will have to enter the campus at the gate in DF Malherbe Drive where the Visitors Centre is situated. You will then be referred to the Visitors Centre where you will have to apply for a day visitor’s card. It is important to note that no one will be able to enter the campus at the Visitors Centre without a formal identification document (e.g. ID book, driver's licence).

4. Dual-frequency card simplifies access to the campus

It is important to have your card ready on entering the campus.

This card will simplify access to the campus considerably, as the card reader will read the card when it is held in a vertical position at the driver’s side window in the direction of the distance reader. Please do not place the card on the dashboard. There is an antenna wire in the card. If the card is placed on the dashboard, you are not exposing the card surface to the reader, and that might influence the antenna’s response to the reader.

Remember, the distance between the reader and the boom is only a few metres.  If you approach the reader at a ’high’ speed, you are not allowing the system to identify your card, match it to the entry in the database, check if you are ‘legal’, and then send a signal to open the boom. 

All five gates are equipped with distance readers. Within the next three weeks, two extra distance readers will also be installed at the Main Gate in Nelson Mandela Drive.
 
Please note that the dual-frequency card is needed only when you enter the campus with a vehicle and you want to activate the distance reader. All the older cards will continue to work at the tag readers. 

5. Use alternative gates

At times, some of the gates carry more traffic than others, especially with the peak morning and afternoon traffic. Gates with less traffic include:

  • The gate in Badenhorst Street
  • The gate in DF Malherbe Drive
  • The gate in Nelson Mandela Drive

You are welcome to make use of one of these alternative gates.

6. Pedestrians

No pedestrian will be able to enter the Bloemfontein Campus without a valid access card. If you have left your card at home or have lost it, you should enter the campus at the gate in DF Malherbe Drive where the Visitors Centre is situated. You will be referred to the Visitors Centre where you can apply for a day visitor’s card. You will still need to produce a formal identification document (e.g. ID book, driver's licence).

7. More information

Email: visitorscentre@ufs.ac.za
Visitors Centre front desk: Tel: +27 51 401 7766 (Mondays-Fridays 07:45-16:30)
Card Division: Tel: +27 51 401 2799 (Mondays-Fridays 07:45-16:30)
Protection Services duty room: +27 51 401 2634 (24 hours)

 

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