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Nutritional status, hospitalization and mortality among patients with sickle cell anaemia in Tanzania
Author(s) -
Cox Sharon Elizabeth,
Makani Julie,
Soka Deogratius,
Newton Charles R,
Williams Tom N,
Prentice Andrew M
Publication year - 2011
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.25.1_supplement.780.18
Reduced growth is common in children with sickle cell anaemia (SCA), but few data exist on associations with long‐term clinical course. We determined if SCA was associated with malnutrition, and if poor nutritional status predicted morbidity and mortality, in an urban Tanzanian SCA cohort. Methods Anthropometric status of SCA (HbSS) patients was determined at enrolment to a hospital‐based cohort (n=1618, 0.5–48y). Prospective surveillance recorded hospitalization and mortality for 5.5y until September 2009. Results The greatest growth deficits were in adolescents and in boys. Independent of age and sex, lower haemoglobin concentration was associated with increased odds of malnutrition in SCA. Higher body mass index and weight‐for‐age z‐score predicted fewer hospital admissions (hazard ratio [HZR]=0.90/z‐score, P=0.04 & HZR=0.87, P=0.02) but height‐for‐age did not. The mortality rate of 2.5/100 person‐years was not associated with any of the anthropometric measures. Conclusions In this non‐birth‐cohort of SCA with significant associated undernutrition, wasting predicted an increased risk of hospital admission. The lack of an association between stunting and risk of hospital admission, or between any measure of malnutrition and death, suggests that reduced growth may be adaptive in this survivor SCA cohort.