Supplementary Material for: Prevalence of Undernutrition and Its Contributing Factors Among Cancer Patients in Africa – A Systematic Review and Meta-Analysis of Observational Studies

Introduction: Cancer poses a significant burden in Africa, where limited resources and infrastructure compound the challenges of managing the disease. Undernutrition, a critical concern among cancer patients, can profoundly affect treatment outcomes and overall prognosis. Despite its importance, the prevalence of undernutrition among African cancer patients remains poorly understood.
Methods: Five major databases were searched for observational studies that reported the prevalence of undernutrition, from inception till February 2024. Study selection, data extraction, and quality assessment were conducted by at least two independent reviewers. The NIH criteria for observational studies were used for quality assessment. A random-effects meta-analysis model was used to estimate the overall undernutrition prevalence, with subgroup analyses conducted based on country and population characteristics.
Results: Twenty-four studies involving 4,283 participants met the inclusion criteria, most studies included children (41%), followed by adults (37%), and women (19%). The overall undernutrition prevalence among African cancer patients was estimated at 32.8% (95% CI, 25.1%, 41.67%) with substantial heterogeneity observed (I² = 95.4%, P < 0.0001). Subgroup analyses revealed significant variations in prevalence across countries and population groups.
Conclusion: Undernutrition is a serious issue among African cancer patients and requires an urgent response with targeted interventions. Tailored nutritional support strategies, considering demographic and regional contexts, are essential for improving patient outcomes.

引言：癌症在非洲造成了沉重的疾病负担，当地有限的医疗资源与基础设施进一步加剧了该疾病的管理难度。营养不良作为癌症患者群体中的关键健康问题，会对治疗效果与整体预后产生严重负面影响。尽管营养不良的临床意义重大，但目前学界对非洲癌症患者的营养不良患病率仍知之甚少。
方法：本研究检索了五大主流数据库，筛选自建库以来至2024年2月期间发表的、报告了营养不良患病率的观察性研究。研究筛选、数据提取与质量评估均由至少两名独立审稿人完成。本研究采用美国国立卫生研究院（National Institutes of Health, NIH）制定的观察性研究质量评价标准开展质量评估，并使用随机效应Meta分析模型估算非洲癌症患者的整体营养不良患病率，同时基于国家与人群特征开展亚组分析。
结果：共有24项符合纳入标准的研究，涉及4283名研究对象，其中纳入儿童患者的研究占比最高（41%），其次为成人患者研究（37%），女性患者相关研究占比19%。经估算，非洲癌症患者的整体营养不良患病率为32.8%（95%置信区间（Confidence Interval, CI）：25.1%~41.67%），研究间存在显著异质性（I²=95.4%，P<0.0001）。亚组分析结果显示，不同国家与人群组的营养不良患病率存在显著差异。
结论：营养不良是非洲癌症患者群体中亟待解决的严重健康问题，亟需开展针对性干预措施予以应对。结合人口统计学与区域特征制定个性化营养支持策略，对改善患者预后至关重要。