Double Burden of Malnutrition among Cancer Outpatients in Nairobi, Kenya: Challenges and Opportunities for Action

Abstract

Introduction: the Kenya National Guidelines for Cancer Management identify nutrition care for persons with cancer as an integral part of cancer treatment. However, contribution of nutrition to cancer disease progression or aversion is yet to be established in Kenya. Methods: this was a facility based cross-sectional study among cancer outpatients seeking treatment at Kenyatta National Hospital and Texas Cancer Centre. Five hundred and twelve adult cancer outpatients with a confirmed diagnosis of stage 1-IV cancers were recruited. Data was collected using a structured questionnaire, anthropometric assessments of weight, height and waist circumference, body composition assessment using bioelectric impedance analysis and abstraction of clinical data from medical records. Proportions and frequencies, measures of central tendency and chi square tests were used in analysis. Results: mean age of participants was 52+13.8 years. Among the top five cancers, those affecting women were leading (breast 28.7%; cervix 23.2%) followed by colorectal (7.6%), oesophagus (7.4%) and prostate cancer (4.7%). More than half (51.4%) of participants were diagnosed at stage 3 and 4. Majority (43.1%) were overweight and obese with more female (50.7%) than male (24.1%). Fourteen percent were underweight (male 25.5%; female 9.4%) with 97.2% reporting inadequate dietary diversity. Mean total body fat (35%) reported was higher than the recommended levels (18-31%). Only 18.6% participants reported to have received nutrition services during hospital visits. Conclusion: double burden of malnutrition remains a challenge among cancer outpatients in Kenya with more cases of overweight and obesity than underweight. Despite this, only 18% receive nutrition interventions.