{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T15:53:28Z","timestamp":1782489208163,"version":"3.54.5"},"reference-count":35,"publisher":"BMJ","issue":"5","license":[{"start":{"date-parts":[[2026,5,6]],"date-time":"2026-05-06T00:00:00Z","timestamp":1778025600000},"content-version":"unspecified","delay-in-days":5,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"AFAS Foundation","award":["Not Applicable"],"award-info":[{"award-number":["Not Applicable"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2026,4,14]]},"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Childhood cancer presents significant challenges in low- and middle-income countries (LMICs), as survival rates remain substantially low. Supportive care, including nutritional support and infection prevention plus management, is crucial in improving outcomes of childhood cancer patients. To develop evidence-based interventions improving supportive care and survival, insight is needed into local prevalences of malnutrition, colonisation and infections, their association with clinical outcomes and the attitude of parents or legal guardians towards nutritional care and infection prevention. The overall aim of this prospective cohort study is to identify modifiable nutritional and infection-related determinants of clinical outcomes at 6 months in children with cancer (1\u201315 years of age) treated with curative intent at the Paediatric Oncology ward of the Shoe4Africa Children\u2019s Hospital at the Moi Teaching and Referral Hospital in Eldoret, Kenya.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and analysis<\/jats:title>\n                    <jats:p>We will conduct a prospective cohort study on 150 children aged 1\u201315 years who are newly diagnosed with cancer and treated with curative intent. During 6 months of follow-up, we will collect clinical data, perform nutritional assessments and monitor pathogen exposure, colonisation and infections. Parents or legal guardians will receive one questionnaire to assess attitudes towards supportive care. Six-month mortality is the primary outcome. Other outcomes include the prevalence and characteristics of malnutrition, rectal colonisation with bacterial and fungal pathogens, infections and neutropenic fever episodes. Statistical analyses will include descriptive statistics, chi-square tests, logistic regression and thematic analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ethics and dissemination<\/jats:title>\n                    <jats:p>The Institutional Research and Ethics Committee has approved the study protocol (FAN: 0004674, protocol version 1.0). Informed consent from parents or legal guardians and assent from children \u226512 years will be obtained. Findings will be disseminated through peer-reviewed publications, presentations at academic conferences and engagement with local and national policymakers and stakeholders. Data from this study could guide the development of locally informed, evidence-based supportive care interventions, with the ultimate goal to improve overall survival for children with cancer in LMICs.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2025-114436","type":"journal-article","created":{"date-parts":[[2026,5,6]],"date-time":"2026-05-06T15:31:29Z","timestamp":1778081489000},"page":"e114436","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["CARE study: prospective cohort study on supportive care among paediatric oncology patients in western Kenya\u2014a study protocol"],"prefix":"10.1136","volume":"16","author":[{"given":"Alice","family":"Gichemi","sequence":"first","affiliation":[{"name":"Department of Child Health and Pediatrics, Moi University, Eldoret, 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Malawi"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7119-1658","authenticated-orcid":false,"given":"Charles Nathaniel","family":"Nessle","sequence":"additional","affiliation":[{"name":"Department of Child Health and Pediatrics, Moi University, Eldoret, Kenya"},{"name":"Department of Pediatric Hematology-Oncology, University of Michigan, Ann Arbor, Michigan, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan-Tom T","family":"van der Bruggen","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology, University Medical Centre Utrecht, Utrecht, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elske","family":"Sieswerda","sequence":"additional","affiliation":[{"name":"Julius Center for Health Sciences and Primary Care, UMC Utrecht, Utrecht, the Netherlands"},{"name":"European Clinical Research Alliance on Infectious Diseases (Ecraid), Utrecht, the 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