ESPE Abstracts

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.

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.