Prevalence and correlates of growth failure in young African patients with sickle cell disease

Area of Science:

• Hematology
• Pediatrics
• Public Health

Background:

• Growth failure (GF) in children with sickle cell disease (SCD) is decreasing in high-income nations, but data from sub-Saharan Africa are scarce.
• Sickle cell disease affects millions globally, with a disproportionate burden in sub-Saharan Africa.

Purpose of the Study:

• To determine the prevalence of growth failure in children with SCD in sub-Saharan Africa.
• To identify factors associated with growth failure in this population.

Main Methods:

• A cross-sectional study was conducted within the CADRE cohort in five sub-Saharan African countries.
• 2,583 participants (SCD patients and healthy controls) aged 5-21 years were recruited.
• Growth failure was defined as height, weight, or BMI below the 5th percentile using WHO growth charts.

Main Results:

• Growth failure was diagnosed in 51% of HbSS, 58% of HbSβ⁰, 44% of HbSC, 38% of HbSβ⁺ SCD patients, and 32% of controls.
• GF was associated with lower parental education, male sex, adolescence (12-14 years), lower blood pressure, HbSS/HbSβ⁰ phenotypes, icterus, lower hemoglobin, higher leukocytes, and microalbuminuria.
• No association was found between GF and the history of SCD-related clinical complications.

Conclusions:

• Growth failure is highly prevalent in children with SCD in sub-Saharan Africa, especially in males and adolescents.
• Factors such as hemolysis and microalbuminuria are associated with GF, highlighting potential targets for intervention.
• The absence of association with clinical complications suggests GF may be an early indicator of disease burden.