ESPE Abstracts

Introduction: Blood transfusion and iron chelation are conventional treatments for β-thalassemia (BTM). Malnutrition affects the growth, efficacy of treatments, and quality of life in children suffering from BTM.

Objective: To evaluate the prevalence of malnutrition (BMI < 3rd centile for age and sex) or BMISDS < -2 in 10 Mediterranean and Middle east countries and the USA in the past 20 years.  

Methods: We performed an electronic search in PubMed, Google Scholar, and Web of Sciences to evaluate the prevalence of malnutrition in children and adults with BTM

Results: Twenty studies were included from 14 Mediterranean and Middle East countries after 2000. The total number of patients was 5554, (2036 children and 3518 adults) reported from 10 countries (Greece, Turkey, Pakistan, India, Thailand, Bangladesh, Egypt. Iran, Iraq, and the USA). In children with BTM, malnutrition prevalence varied significantly from 7.8% in the USA to 74% in Iran. In adults with BTM, the prevalence of malnutrition varied from 5.2 % in the USA to 74.5% in Thailand. The pooled prevalence of malnutrition in children was 42.1% and for adults was 35%. The overall pooled prevalence In adults and children with BTM is 40.1%. The prevalence of malnutrition was significantly higher in children versus adults with BTM and in lower-income countries versus middle and higher-income countries.

Discussion: The results of this study show that malnutrition, especially underweight is prevalent in thalassemic children, adolescents, and adults. The nutritional status of thalassemic varies greatly in different countries and appears to be related to their nutrient intake of macro and micronutrients. Therefore, nutritional interventions and nutrition education can play important roles in achieving normal growth and quality of life in thalassemic children and adolescents. Evidence showed that stunted growth is related to underlying malnutrition or irregular frequency of blood transfusions or compliance to chelation therapy

Conclusion: It appears that regular nutritional assessment, improving the dietary intake, and correction of macro and micronutrient deficiencies can markedly improve nutritional status and linear growth in patients with BTM.