Acute malnutrition is common in Malawian patients with a Wilms tumour: A role for peanut butter

Israëls T, Borgstein E, Jamali M, de Kraker J, Caron HN, Molyneux EM.

This study concluded that acute malnutrition, superimposed on chronic malnutrition, is common in patients with Wilms tumour in Malawi. Chiponde, a peanut butter based ready-to-use-therapeutic-food, is an attractive means of nutritional support which needs further study.

The study included all new patients with the clinical diagnosis of a Wilms tumour. Anthropometric parameters, tumour size and serum levels of micronutrients at diagnosis were documented. During therapy oral feeds were encouraged and a locally made ready to use therapeutic peanut butter-based food (chiponde) supplied.

High rates of both acute and chronic (stunting) malnutrition were found in patients with Wilms tumour at diagnosis (45-55%), much higher than in community controls (11%). Patients with larger tumours had more severe acute malnutrition (r = -0.88, P < 0.01). With a supply of chiponde, 7 of 18 patients had a >5% increase in corrected weight during preoperative chemotherapy. Patients with a more positive nutritional course had a better tumour response to chemotherapy (r = 0.52, P < 0.05). Surprisingly, few micronutrient deficiencies were found, except for low serum levels of vitamin A (44% of patients).

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