ESPE Abstracts (2022) 95 P1-334

ESPE2022 Poster Category 1 Multisystem Endocrine Disorders (24 abstracts)

Multi-continent comparison of the prevalence of short stature and undernutrition in children and adolescents with homozygous sickle cell disease: Africa, USA, Europe, and Middle East area

Ashraf Soliman 1 , Nada Alaaraj 1 , Nada Soliman 2 & Ilham Bilial 1


1Hamad General Hospital, Doha, Qatar; 2Primary Health Care, Alexandria, Egypt

Background: Poor growth and under-nutrition are common in children with sickle cell disease (SCD). This review summarizes evidence of impaired linear growth and weight gain in children with SCD in different regions of the world in the past 25 years.

Methods: A literature search was conducted on Medline/PUBMED, Google scholar, and SCOPUS, for studies published in English during the past 25 years, using the keywords sickle cell combined with nutrition, anthropometry, growth, height and weight, body mass index.

Results: Twenty-one studies (cross-sectional and longitudinal) were included in the final anthropometric analysis. The prevalence of short stature (Height SDS (HAZ)< -2 and underweight (weight for age Z score (WAZ) or BMI Z score BMI Z < -2 was calculated in each study. Prevalence data from each region complied and the three regions were compared using proportion statistics. We reviewed eight studies from North America and Europe, nine from Africa (Egypt, Nigeria, Cameroon, Central Africa, Ivory Coast, Senegal, Ghana, and Zambia), and 5 from the Middle East area (Yemen, Qatar, Iraq, Bahrain, and Oman). Most studies were observational with wide variations in sample size and selection of reference growth data. Results of cumulative prevalence per region are presented in the table. The prevalence of short stature and underweight and wasting were significantly higher in SCD children from the Middle East and Africa compared to Europe and USA. The higher prevalence of growth impairment in African children with SCD can be explained in part by the high occurrence of nutritionally related growth abnormalities in non-SCD children in these countries (around 25% of children) which adds to growth impairment in SCD.

Table: Prevalence of growth abnormalities in SCD in different regions of the World.
Region Africa Europe/USA Middle East
Number of studies 9 8 5
Total No 12018 733 310
HAZ <-2SD 20% 15.4% 33%
P-value A vs E 0.0024 E vs M <0.0001 M vs A <0.0001
Total No. 3200 1435 199
WAZ or BMI Z<-2SD 43.54% 9.64% 51.5%
P-value Avs E <0.0001 E vs M <0.0001 M vs A 0.0282
A = Africa, E= Europe and USA, M = Middle East

Conclusions: The high prevalence of growth abnormalities in children and adolescents with SCD necessitates close monitoring of growth and nutritional status as an essential requirement for early diagnosis and proper management of growth failure and nutritional intervention.

Volume 95

60th Annual ESPE (ESPE 2022)

Rome, Italy
15 Sep 2022 - 17 Sep 2022

European Society for Paediatric Endocrinology 

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