Prevalence, severity and factors associated with peripheral neuropathy among cancer patients on chemotherapy at Moi Teaching and Referral Hospital, Eldoret Kenya.

Abstract

Background: Peripheral neuropathy among cancer participants on chemotherapy is a disabling condition. It is majorly associated with drugs such as platinum compounds, taxane, vinca alkaloids among others. Severe peripheral neuropathy may require reduction of the chemotherapy dose or complete cessation. The prevalence, severity and associated factors of peripheral neuropathy among cancer participants on chemotherapy in our set up has not been clearly defined. Objectives: The purpose of the study was therefore to determine the prevalence, severity and factors associated with peripheral neuropathy among participants receiving chemotherapy at Moi Teaching and referral hospital (MTRH). Methods: This was a descriptive cross-sectional study investigating peripheral neuropathy among cancer participants on chemotherapy at MTRH. Systematic sampling was used to recruit 211 cancer participants on chemotherapy. The first patient was selected randomly using the sampling randomizer software thereafter every fourth patient was recruited into the study. A structured questionnaire was used to collect demographic, clinical and disease characteristics data. The Total Neuropathy Score (TNS) was used to measure peripheral neuropathy among the study participants. Data was analyzed using both descriptive and inferential statistics. The prevalence of peripheral neuropathy among patient on chemotherapy was calculated as those with peripheral neuropathy as proportion of the study sample and expressed as a percentage. Bivariate analysis was used to calculate the severity of PN and results are presented as frequencies, percentages and P Values. Factors associated with PN were analysed using multivariate logistic regression. Results are presented as odds ratios and confidence intervals. Results: The study found that 70.1% of participants at MTRH had peripheral neuropathy, of which 49.3% had mild symptoms, 42.6% had moderate symptoms, and 8.1% had severe symptoms. Autonomic symptoms were the most common at 84.8% followed by sensory symptoms at 57.8%. Amongst the factors associated with CIPN, age was found to be a significant factor, with older participants at a higher risk of getting CIPN. Participants with comorbidities such as HIV, diabetes mellitus, and hypertension also had increased risk of CIPN although not statistically significant with a P value of 0.212. Conclusion: The prevalence of CIPN was high among patient on chemotherapy at MTRH though most patient had mild symptoms. Recommendations: We highly recommend for the introduction of routine screening protocol for peripheral neuropathy among patients receiving chemotherapy at MTRH as this can help mitigate the severity of symptoms and improve patient quality of life and outcomes