Complementary and alternative medicine use and associated factors among children with cancer, seeking care at the Uganda Cancer Institute

Abstract

Background: Complementary and Alternative Medicine (CAM) is widely used among children with cancer, with global utilization ranging from 6% to 91%. According to the National Center for Complementary and Integrative Health (NCCIH) of the United States of America, CAM includes natural products, mind-body practices, and manipulative therapies, often used alongside or as an alternative to conventional treatments. While CAM can complement mainstream medicine, its inappropriate use without a healthcare provider's knowledge may lead to adverse effects and drug-herb interactions. Evidence suggests potential risks when combining CAM with antineoplastic drugs. This study examined the prevalence and factors associated with CAM use among children with cancer seeking care at the Uganda Cancer Institute to understand its impact on pediatric oncology care. Methodology: This study employed a cross-sectional design utilizing both quantitative and qualitative methods of data collection. All children up to 17 years old with a cancer diagnosis who sought care at the UCI during the study period were included in the study. STATA version 16 was used to analyze quantitative data. Both bivariate and multivariate modified Poisson regression were employed to assess the factors associated with CAM use. Confounding and interaction were tested at the multivariate level. Variables that achieved a p<0.05 at a 95% Confidence Interval were considered statistically significant. Thematic analysis was used for qualitative data. Results: Out of the 395 children with cancer seeking care at UCI, 69.9% had used at least one form of CAM, with herbal remedies (44.8%) and spiritual therapy (54.7%) being the most common. Most children began using CAM after their cancer diagnosis and used it alongside conventional therapy. Multivariate analysis revealed that an average monthly income of 50,000-100,000 (APR: 0.82, 95% CI: 0.71-0.94, p=0.005), diagnosis of leukemia (APR: 1.49, 95% CI: 1.01-2.18, p=0.043), and experiencing treatment side effects (APR: 1.23, 95% CI: 1.09-1.40, p=0.001) were significantly associated with CAM use. Qualitative findings revealed that financial constraints, poor healthcare accessibility, high treatment costs, and side effects contributed to CAM use. Conclusion: This study highlights a widespread use of CAM among children with cancer at the Uganda Cancer Institute. Although CAM may pose significant benefits for cancer outcomes, the study calls for further research on the effectiveness of CAM in improving cancer outcomes to guide policy on integrating CAM into mainstream healthcare.