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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 Communication and Brand Management receives two prestigious international awards
2015-07-07

Lelanie de Wet, Lacea Loader and Leonie Bolleurs

The Department of Communication and Brand Management at the University of the Free State (UFS) received two of the six Gold Quill Awards – that were awarded to South African companies and institutions - at the International Association of Business Communicator’s (IABC) Excellence Gala ceremony in San Francisco, US on 15 June 2015.

The awards ceremony formed part of the 2015 IABC World Conference, which took place from 14-17 June 2015. The department received a Gold Quill Excellence Award for its social media campaign, UFS #FaceOfFacebook and a Gold Quill Merit Award for the B Safe Take Action campaign.

From the 15 countries that entered, a total of 120 Gold Quill Excellence awards and 189 Gold Quill Merit awards were awarded. Other South African award winners included Barclays Africa Group Limited, Mediclinic and the Cape Peninsula University of Technology (CPUT).

This is the second year in a row that the UFS has been recognised by the IABC for its communication projects. In 2014, the department was awarded the Jake Wittmer Research Award for a Stakeholder Perception Audit conducted in February 2014. The audit was considered – by the IABC - as one of the best breakthrough strategies used by a university to measure the perceptions of its stakeholders.This made the UFS the first tertiary institution in Africa to receive the research award. The stakeholder perception audit also received an Africa Gold Quill in 2014.

"Being recognised by a global association such as the IABC for the second time, is a great honour and I am very proud of what my colleagues have achieved by entering the two campaigns. Winning the awards is a true indication of what can be done when a team of expert communicators is committed towards engaging their target audiences with campaigns that speak of quality and innovation. The fact that the UFS is one of only two tertiary education institutions in the country to receive these prestigious awards, makes it even more special," said Lacea Loader, Director: Communication and Brand Management at the UFS.

IABC World and Africa conferences 2015 

The IABC is a global membership association with a network of 12 000 members in more than 80 countries, representing many of the Global Fortune 500 companies. It serves professionals in the field of business communication, bringing together the profession’s collective disciplines.

With the theme: Changing landscape: Informing the future, the 2015 world conference was attended by over 1 200 delegates from across the world. Delegates were offered an opportunity for learning, discovering, and connecting. Loader also made a presentation entitled ‘Award-winning measurement endorses sound reputation management strategy’ at the world conference.

The department will also be receiving two Africa Gold Quill Awards from the Africa chapter of the IABC for the same campaigns on 30 July 2015 in Johannesburg.

UFS #FaceOfFacebook Campaign

The university received a Gold Quill Excellence Award for its social media campaign, UFS #FaceOfFacebook. This initiative originated in the university’s commitment to its Human Project, which sets the standard for good behaviour and care.

Lelanie de Wet, Manager: Social Media and Website Content and project leader of UFS #FaceOfFacebook, said the project was born from the need to communicate with students. Thus a virtual friend, #FaceOfFacebook, was created. “Yearly auditions are being held to choose the new face representing the UFS on Facebook. Short video clips of the #FaceOfFacebook – whether it is attending events or communicating important messages - are posted on the UFS Facebook page. The successful candidate holds the title #FaceOfFacebook for 12 months.

“When I look at a campaign such as #FaceOfFacebook, from the time it took its first tentative steps in 2013, and see how it inspired staff and students alike, my heart swells with pride. Often you can see the impact you have made only in retrospect. The ripples you send into the world will inevitably create waves,” she said.

B Safe Take Action Campaign

The B Safe Take Action campaign of the university received a Gold Quill Merit award from the IABC.

The campaign was activated in September 2013. “It targeted on- and off-campus students and staff, aiming to create social ownership of personal safety, and to raise awareness of the safety measures put in place by the university,” said Leonie Bolleurs, Manager: Internal Communication and project manager of the campaign.

The campaign looked at a number of safety aspects, focusing not only on crime but also on being safe from road accidents and stress/burnout.

It is the second time this year that the BSafe campaign has been recognised for its innovative strategy. Earlier this year it received a PRISM Award (Gold) from the Public Relations Institute of Southern Africa (PRISA). The annual PRISM Awards are about recognising and celebrating great public relations campaigns.

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