Socioeconomic and Clinical Determinants of Nutritional Phenotypes among Children with Sickle Cell Disease

Abstract

Background and Objective: Sickle cell anemia (SCA) remains a critical global health challenge, disproportionately affecting sub-Saharan Africa, India, and the Middle East. It significantly impacts the quality of life of affected children, with malnutrition further exacerbating the disease severity and increasing the risk of hospitalization and death. This study aims to explore the socioeconomic and clinical risk factors driving malnutrition in this vulnerable population.

Methods: A cross-sectional study was conducted among children with sickle cell disease attending the outpatient clinic of Murtala Muhammad Specialist Hospital in Kano, Nigeria. Simple random sampling was used to select participants. Anthropometric measurements were used to calculate weight for height z score, classifying malnutrition based on the World Health Organization standards. Multivariable logistic regression was employed to identify factors associated with malnutrition, with sub-analysis focusing on severe acute malnutrition in children with SCA.

Results: A total of 561 children with SCA participated in the study, with 141 (25.1%) under-five and 420 (74.9%) older children aged 5–12  years. Severe acute malnutrition was more prevalent among older children (16.5%) compared to children under 5 years (13.6%) with SCA. Multivariable analysis showed that for each additional year, an increase in age, the likelihood of severe acute malnutrition among SCA children increased by 13% (adjusted odds ratio: 1.13, confidence interval: 1.04, 1.24, p = 0.004).

Conclusion and Implications for Translation: The study highlighted significant age-related differences in the nutritional status of children with SCA. It also highlights the need for targeted nutritional interventions and care approaches to address malnutrition among older children with SCA.