Twelve-month observational study of children with cancer in 41 countries during the COVID-19 pandemic

Introduction Childhood cancer is a leading cause of death. It is unclear whether the COVID-19 pandemic has impacted childhood cancer mortality. In this study, we aimed to establish all-cause mortality rates for childhood cancers during the COVID-19 pandemic and determine the factors associated with mortality. Methods Prospective cohort study in 109 institutions in 41 countries. Inclusion criteria: children <18 years who were newly diagnosed with or undergoing active treatment for acute lymphoblastic leukaemia, non-Hodgkin's lymphoma, Hodgkin lymphoma, retinoblastoma, Wilms tumour, glioma, osteosarcoma, Ewing sarcoma, rhabdomyosarcoma, medulloblastoma and neuroblastoma. Of 2327 cases, 2118 patients were included in the study. The primary outcome measure was all-cause mortality at 30 days, 90 days and 12 months. Results All-cause mortality was 3.4% (n=71/2084) at 30-day follow-up, 5.7% (n=113/1969) at 90-day follow-up and 13.0% (n=206/1581) at 12-month follow-up. The median time from diagnosis to multidisciplinary team (MDT) plan was longest in low-income countries (7 days, IQR 3-11). Multivariable analysis revealed several factors associated with 12-month mortality, including low-income (OR 6.99 (95% CI 2.49 to 19.68); p<0.001), lower middle income (OR 3.32 (95% CI 1.96 to 5.61); p<0.001) and upper middle income (OR 3.49 (95% CI 2.02 to 6.03); p<0.001) country status and chemotherapy (OR 0.55 (95% CI 0.36 to 0.86); p=0.008) and immunotherapy (OR 0.27 (95% CI 0.08 to 0.91); p=0.035) within 30 days from MDT plan. Multivariable analysis revealed laboratory-confirmed SARS-CoV-2 infection (OR 5.33 (95% CI 1.19 to 23.84); p=0.029) was associated with 30-day mortality. Conclusions Children with cancer are more likely to die within 30 days if infected with SARS-CoV-2. However, timely treatment reduced odds of death. This report provides crucial information to balance the benefits of providing anticancer therapy against the risks of SARS-CoV-2 infection in children with cancer

Investigation of the Dietary Intake and Health Status in East Africa in the 1960s: A Systematic Review of the Historic Oltersdorf Collection

We have recently reported on the myriad health benefits of traditional East African foods and food habits. However, this region continues to experience a nutrition transition whereby traditional, well-tried foods have been systematically replaced with the products of multinational corporations. The health-related impact has been devastating, as evidenced by current non-communicable disease (NCD) trends. The purpose of the present investigation was to review the historic Oltersdorf Collection (data collated by the Max-Planck Nutrition Research Unit, Bumbuli Tanzania from the 1930s to 1960s) to determine if adherence to traditional East African food habits was positively associated with health status indices in populations residing in Tanzania, Kenya and Uganda during this period. The systematic review process resulted in six investigations being identified. Published between 1963 and 1969, these are likely the first investigations to provide original data pertaining to dietary intake/adequacy and health status indices within specific East African cohorts. Overall, the review revealed that many ethnic groups did not exhibit adequate dietary intake and did not consume a diversity of traditional whole foods representative of the wide spectrum of food choices available within the region at this time. NCDs such as obesity, hypertension, and type 2 diabetes were not reported in any investigation. However, there was substantial reporting of malnutrition-related and infectious diseases, particularly among children. The present review supports the contention that the shift from a traditional, diversified diet to a simplified, monotonous diet may have occurred with the onset of cash-crop farming. For resolution of nutrition-related epidemics currently plaguing Africa, including NCDs and malnutrition-related diseases (i.e., the double burden) it is critically important to investigate and disseminate evidence related to the fundamental contributors to the nutrition transition

Twelve-month observational study of children with cancer in 41 countries during the COVID-19 pandemic

Childhood cancer is a leading cause of death. It is unclear whether the COVID-19 pandemic has impacted childhood cancer mortality. In this study, we aimed to establish all-cause mortality rates for childhood cancers during the COVID-19 pandemic and determine the factors associated with mortality