ESPE Abstracts

Introduction: Quality of life (QoL), comprises physical, psychological, environmental, and social aspects, is an index designed to measure the burden of chronic diseases and evaluate the treatment outcome. Thalassemia major (BTM) is a chronic disease in children that harms children QoL by interrupting physical function, emotional function, social function, and school function. Objectives

Aim: This study aims to identify the link between nutritional status and QoL among children and adolescents with thalassemia major.

Methods: We reviewed the articles used three databases including Pubmed, Google scholar and Science Direct, and NCBI with keywords: “quality of life” AND “children” AND “thalassemia major” AND “malnutrition” AND “BMI”. The articles of the past 20 years were included.

Results: out of 25 articles addressing QoL only 4 articles addressed the nutritional status in relation to QoL and were reviewed according to the inclusion criteria. All the studies showed that the prevalence of Malnutrition and/or low BMI is considerably high in patients with BTM. In the 4 studies, (n= 676 children and adolescents) the score of QoL among patients with BTM was lower than that for healthy control children. In an Indian study, on 328 children with BTM, multiple linear regression analysis revealed that malnutrition negatively impacted total QoL (unstandardized beta [standard error], -4.4 [1.7]; P=0.009) as well as the physical and emotional domains of QOL adjusted for age, sex, place of residence, parents’ educational level, and socioeconomic status. In two controlled Egyptian studies on 127 and 64 thalassemic children respectively, thalassemic children with significantly lower BMI, BMISDS and Height SDS had significantly decreased total (Physical, emotional social and school QoL) compared to healthy controls. Household income and high serum ferritin were statistically significant predictors for poor emotional and social QoL respectively. A study from Sri Lanka showed that thalassemic patients with undernutrition (n= 157) had lower total, psychological and school QoL scores compared to thalassemic patients with normal nutrition (n= 85). In these studies, factors that possibly contributed to decreased QoL and nutritional status in children with BTM included low household income, parents’ education and efficiency of transfusion and iron chelation.

Conclusion: regular anthropometric and nutritional assessment and appropriate nutritional interventions should be incorporated into the therapeutic plans for thalassemic patients to improve their growth status and QoL.