Br J Haematol. 2018 Nov 22. doi: 10.1111/bjh.15638. [Epub ahead of print]
Prevalence and correlates of growth failure in young African patients with sickle cell disease.
Alexandre-Heymann L1, Dubert M1,2, Diallo DA3, Diop S4, Tolo A5, Belinga S6, Sanogo I5, Diagne I7, Wamba G8, Boidy K4, Ly ID7, Kamara I4, Traore Y2, Offredo L2, Jouven X2,9, Ranque B1,2.
Growth failure (GF) in children with sickle cell disease (SCD) tends to decline in high-income countries, but data are lacking in sub-Saharan Africa. We performed a cross-sectional study nested in the CADRE (Cœur, Artères et DREpanocytose) cohort in Mali, Senegal, Cameroon, Gabon and the Ivory Coast. SCD patients and healthy controls aged 5-21 years old were recruited (n = 2583). Frequency of GF, defined as a height, weight or body mass index below the 5th percentile on World health Organization growth charts, was calculated. We assessed associations between GF and SCD phenotypic group, clinical and biological characteristics and history of SCD-related complications. GF was diagnosed in 51% of HbSS, 58% of HbSβ0 , 44% of HbSC, 38% of HbSβ+ patients and 32% of controls. GF in patients was positively associated with parents' lower education level, male sex, age 12-14 years, lower blood pressure, HbSS or HbSβ0 phenotypes, icterus, lower haemoglobin level, higher leucocyte count and microalbuminuria. No association was found between GF and clinical SCD-related complications. In sub-Saharan Africa, GF is still frequent in children with SCD, especially in males and during adolescence. GF is associated with haemolysis and microalbuminuria, but not with the history of SCD-related clinical complications.
Africa; SCD complications; Sickle cell disease; growth; haemolysis