The effect of sickle cell anemia on the linear growth of Nigerian children
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Updated: Oct 28, 2025
A Precision Medicine Tool for Measurement and Monitoring of Hemoglobin S in Sickle Cell Disease Patients Receiving Transfusion Therapy
Ugo Nnenna Chikani1, Adaobi Bisi-Onyemaechi1, Ijeoma Ohuche1
1Department of Paediatrics, University of Nigeria Ituku Ozalla Campus, Enugu, Nigeria.
Insights
Growth failure is highly prevalent in children with sickle cell anaemia (SCA) in West Africa, affecting 84.7% of patients. This growth deficit worsens with age and later diagnosis, highlighting the need for targeted interventions.
Area of Science:
- Pediatric Hematology
- Growth and Development Studies
- Public Health in Africa
Background:
- Sickle cell anaemia (SCA) is a prevalent condition in West African children, yet data on growth patterns, specifically height velocity and growth failure, remain limited.
- Advances in clinical care necessitate an understanding of potential spatial and secular trends in SCA patient growth.
- This study addresses the critical need for data on growth failure prevalence and its determinants in pediatric SCA patients in the region.
Purpose of the Study:
- To determine the prevalence of growth failure (GF) among pediatric patients with SCA.
- To investigate the correlation between growth failure and patient factors including age, gender, and age at diagnosis.
- To establish baseline data on height velocity in SCA patients for future trend analysis.
Main Methods:
- A prospective longitudinal cohort study was conducted involving pediatric SCA patients over two years.
- Height measurements were taken at baseline and at 3, 6, and 12-month intervals, plotted on WHO growth charts.
- Height velocities were calculated and compared to WHO standards; growth failure was defined as height below the 10th percentile.
Main Results:
- A cohort of 316 children (aged 1-18 years) with SCA was evaluated, with 57.4% being male.
- The overall prevalence of growth failure and short stature was 84.7%, highest in post-pubertal participants (94.1%).
- Age was the most significant predictor of growth velocity deficit (R²=0.045, p=0.001).
Conclusions:
- A high prevalence of growth failure exists in West African children and adolescents with SCA.
- Growth failure in SCA patients intensifies with increasing age and later age at diagnosis.
- Findings underscore the need for early diagnosis and ongoing monitoring of growth in pediatric SCA populations.
Objectives:
Despite the high prevalence of children with sickle cell anaemia (SCA) in West Africa, there is paucity of data on the height velocity and prevalence of growth failure in SCA patients. With advances in clinical care of SCA patients, could there be a spatial and secular trend in the growth pattern of these children? Hence, the compelling needs to embark on this study. The objectives of the study were to determine the prevalence of growth failure among patients with SCA and its correlation with age, gender and age at diagnosis.
Methods:
A Prospective longitudinal study of a cohort of sickle cell anaemic paediatric patients from Pediatrics SCA Clinic, University of Nigeria Teaching Hospital, Ituku Ozalla. Patients were enrolled over a period of two years using a non-parametric convenient sampling method. Their heights were measured at baseline, three months, six months and at 12 months intervals and subsequently plotted on a standard WHO growth chart. The height velocities at different monthly intervals were calculated and compared with the WHO standard normal linear growth rates) for children (used as control) to identify those with GF. (i.e. <10th percentile). The main outcome measures were the mean height velocities at different months' intervals calculated and compared using the repeated measurement analysis of variance (ANOVA) and the Wilcoxon signed test.
Results:
A cohort of 316 children aged 1-18 years with SCA was evaluated with a male preponderance of 161 (57.4%). The mean age and age at diagnosis were 11.04 ± 5.56 and 4.2 ± 1.7 years, respectively. The prevalence of growth failure and short stature was 84.7%. The burden of GF was highest among post-pubertal participants (94.1%). The most important predictor of growth velocity deficit was age (R2=0.045, standard β coefficient = -0.22, t=-03.51, p=0.001).
Conclusions:
The study demonstrated high prevalence of growth failure in children and adolescents with SCA which intensified with advancement in age and older age at diagnosis.
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