Prevalence of Malnutrition, Its Associated Factors, and Challenges Faced Among Pediatric Oncology Patients at Mulago National Referral Hospital: Mixed Study Design

Prevalence of Malnutrition, Its Associated Factors, and Challenges Faced Among Pediatric Oncology Patients at Mulago National Referral Hospital: Mixed Study Design | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Prevalence of Malnutrition, Its Associated Factors, and Challenges Faced Among Pediatric Oncology Patients at Mulago National Referral Hospital: Mixed Study Design Samuel Okello, John Michael Okusa, Ezekiel Mupere, Nicolette Nabukeera Barungi, and 9 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7769121/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 12 You are reading this latest preprint version Abstract Introduction: Malnutrition is a public health problem, affecting up to 90% of pediatric oncology patients globally and 25% to 50% in sub-Saharan Africa. It results into poor treatment outcomes. Objective To determine the prevalence of malnutrition, its associated factors and challenges faced in maintaining adequate nutrition status among pediatric oncology patients receiving chemotherapy at Mulago National Referral Hospital. Methods The study employed convergent parallel mixed-methods design with a cross-sectional design for quantitative data and exploratory descriptive design for qualitative data. The quantitative component included 196 pediatric oncology patients receiving chemotherapy systematically sampled and the qualitative component involved 10 caregiver interviews and 6 healthcare worker key informant interviews purposively sampled. Quantitative data were analyzed using modified Poisson regression and qualitative data via inductive thematic analysis. Results The prevalence of malnutrition among pediatric oncology patients was 27.6% (95% CI: 21.7%-34.3%). The factors associated with malnutrition included; lack of strong family support (adjusted prevalence ratio (aPR): 1.981, p-value = 0.003), use of herbal medicine (aPR: 1.569, p-value = 0.048), lack of dietary diversity (aPR: 1.882, p-value = 0.007), and swallowing difficulties (aPR: 1.750, p-value = 0.006). The challenges faced in maintaining adequate nutrition included; cancer and chemotherapy-related complications, financial constraints, limited caregiver knowledge, health system deficiencies, and psychosocial burdens. Conclusion Nearly 1 in 4 pediatric oncology patients undergoing chemotherapy had malnutrition. Factors associated with malnutrition included; lack of family support, use of herbal medicine, poor dietary diversity, difficulty in swallowing. The challenges included; cancer and chemotherapy-related complications, financial constraints, knowledge gap, and psychosocial burdens. Strengthening nutritional assessment, integrating nutrition into cancer care, and health educating caregivers on best nutritional practices are critical in reducing malnutrition. Malnutrition Pediatric Oncology patients challenges adequate nutrition Full Text Additional Declarations No competing interests reported. Supplementary Files SUPPLEMENTARYTOOLFORQUALITATIVEDATACOLLECTION.docx Cite Share Download PDF Status: Under Review Version 1 posted Editorial decision: Revision requested 24 Mar, 2026 Reviews received at journal 07 Dec, 2025 Reviews received at journal 07 Dec, 2025 Reviewers agreed at journal 06 Dec, 2025 Reviews received at journal 04 Dec, 2025 Reviewers agreed at journal 04 Dec, 2025 Reviewers agreed at journal 01 Dec, 2025 Reviewers invited by journal 01 Dec, 2025 Editor assigned by journal 25 Nov, 2025 Editor invited by journal 24 Oct, 2025 Submission checks completed at journal 16 Oct, 2025 First submitted to journal 16 Oct, 2025 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-7769121","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":554177653,"identity":"064e5cbe-f1b2-44d6-b7cb-9d557d76b1dd","order_by":0,"name":"Samuel 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Design","fulltext":[],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":false,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":true,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":true,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-nutrition","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"nutn","sideBox":"Learn more about [BMC Nutrition](http://bmcnutr.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/nutn/default.aspx","title":"BMC Nutrition","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Malnutrition, Pediatric Oncology patients, challenges, adequate nutrition","lastPublishedDoi":"10.21203/rs.3.rs-7769121/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7769121/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eIntroduction:\u003c/h2\u003e\u003cp\u003eMalnutrition is a public health problem, affecting up to 90% of pediatric oncology patients globally and 25% to 50% in sub-Saharan Africa. It results into poor treatment outcomes.\u003c/p\u003e\u003ch2\u003eObjective\u003c/h2\u003e\u003cp\u003eTo determine the prevalence of malnutrition, its associated factors and challenges faced in maintaining adequate nutrition status among pediatric oncology patients receiving chemotherapy at Mulago National Referral Hospital.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e\u003cp\u003eThe study employed convergent parallel mixed-methods design with a cross-sectional design for quantitative data and exploratory descriptive design for qualitative data. The quantitative component included 196 pediatric oncology patients receiving chemotherapy systematically sampled and the qualitative component involved 10 caregiver interviews and 6 healthcare worker key informant interviews purposively sampled. Quantitative data were analyzed using modified Poisson regression and qualitative data via inductive thematic analysis.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e\u003cp\u003eThe prevalence of malnutrition among pediatric oncology patients was 27.6% (95% CI: 21.7%-34.3%). The factors associated with malnutrition included; lack of strong family support (adjusted prevalence ratio (aPR): 1.981, p-value\u0026thinsp;=\u0026thinsp;0.003), use of herbal medicine (aPR: 1.569, p-value\u0026thinsp;=\u0026thinsp;0.048), lack of dietary diversity (aPR: 1.882, p-value\u0026thinsp;=\u0026thinsp;0.007), and swallowing difficulties (aPR: 1.750, p-value\u0026thinsp;=\u0026thinsp;0.006). The challenges faced in maintaining adequate nutrition included; cancer and chemotherapy-related complications, financial constraints, limited caregiver knowledge, health system deficiencies, and psychosocial burdens.\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e\u003cp\u003eNearly 1 in 4 pediatric oncology patients undergoing chemotherapy had malnutrition. Factors associated with malnutrition included; lack of family support, use of herbal medicine, poor dietary diversity, difficulty in swallowing. The challenges included; cancer and chemotherapy-related complications, financial constraints, knowledge gap, and psychosocial burdens. Strengthening nutritional assessment, integrating nutrition into cancer care, and health educating caregivers on best nutritional practices are critical in reducing malnutrition.\u003c/p\u003e","manuscriptTitle":"Prevalence of Malnutrition, Its Associated Factors, and Challenges Faced Among Pediatric Oncology Patients at Mulago National Referral Hospital: Mixed Study Design","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-12-03 04:32:02","doi":"10.21203/rs.3.rs-7769121/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2026-03-24T11:45:12+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-12-07T22:28:37+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-12-07T08:03:17+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"281665854085868582097531946616482221402","date":"2025-12-06T14:09:31+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-12-04T07:29:04+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"98267634045186205912122831358284456934","date":"2025-12-04T05:41:13+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"70089921701577466249421329289556306603","date":"2025-12-02T01:33:26+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-12-01T17:01:12+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-11-25T11:28:00+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2025-10-24T13:11:15+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-10-16T18:59:42+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Nutrition","date":"2025-10-16T18:56:25+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-nutrition","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"nutn","sideBox":"Learn more about [BMC Nutrition](http://bmcnutr.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/nutn/default.aspx","title":"BMC Nutrition","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"5c16c9df-c02c-4c4d-93f1-9b9ff6d5cbef","owner":[],"postedDate":"December 3rd, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2026-04-21T15:39:30+00:00","versionOfRecord":[],"versionCreatedAt":"2025-12-03 04:32:02","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-7769121","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7769121","identity":"rs-7769121","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}