Table 1 Studies of anthropometric characteristics of individuals living with sickle cell disease in Africa
From: Nutritional perspectives on sickle cell disease in Africa: a systematic review
Authors and year of publication | Location | Ages | No. of subjects | Control group | Weight | Height | Body mass index | Other assessments |
|---|---|---|---|---|---|---|---|---|
VanderJagt et al., 1997 [22] | Jos, Nigeria | 10 months-14 years (mean 7 years for males; mean 6 years for females) | 13 | 17 age- and gender-matched controls | Significantly lower weight in males with SCD | No significant differences in height reported | No statistical difference in BMI as both weight and height were lower for SCD patients | • Significantly lower head circumference in males with SCD versus controls • No differences in MUAC or triceps skin fold • No differences reported for females |
Soliman et al., 1999 [23] | Alexandria, Egypt | Mean 7 years | 110 | 200 healthy age-matched children, 30 children with constitutional growth delay, 25 children with growth hormone deficiency | N/A | • Height and growth velocity significantly lower in SCD patients than healthy controls • Bone age delay in SCD patients by 2.4 years | • BMI not significantly different between SCD patients and healthy controls | • Lower MUAC and triceps skin fold thickness in SCD patients versus healthy controls • Significant age delays in puberty in SCD patients |
Aderibigbe et al., 1999 [24] | Ilorin, Nigeria | 18–54 years (mean 22 years) | 64 | 60 adults aged 18–57 | Significantly lower weight in individuals with SCD | Significantly shorter height in individuals with SCD | N/A | |
VanderJagt et al., 2000 [25] | Jos, Nigeria | 3–20 years | 48 | 51 healthy controls | Significantly lower weight in males with SCD aged 10–18 years; no differences for females | No differences | Significantly lower BMI for males with SCD aged 10–18; no differences for females | • Significantly lower fat free mass in males with SCD aged 10–18 • Significantly higher body fat and % body fat in individuals with SCD aged > 10 years |
Vandegt et al., 2002 [26] | Jos, Nigeria | Mean 13 years for males and females | 72 | 68 age- and gender-matched controls | Significantly lower weight in females and males with SCD | Significantly lower height in females and males with SCD | Significantly lower BMI in females and males with SCD | |
VanderJagt et al., 2002 [27] | Jos, Nigeria | 8–22 years (mean 14 years for males; mean 13 years for females) | 80 | 41 male and 38 female age-matched controls; 51 male and 71 female additional controls for ultrasound component | Significantly lower weight in females and males with SCD | Significantly lower height in females and males with SCD | Significantly lower BMI in males and females with SCD | • Significantly lower bone density in individuals with SCD by ultrasound measurement • Some differences in serum markers of bone resorption and formation • No differences in triceps skin fold • Significantly lower MUAC, FFM, and % FFM in males and females with SCD; males with SCD also had significantly lower body fat |
Oredugba et al., 2002 [28] | Lagos, Nigeria | 1–18 years (mean 10 years) | 117 | 122 children and adolescents aged 1–18 years from well-baby clinics and surgical outpatient unit | Significantly lower weight in individuals with SCD aged 18 years | No differences | N/A | • Significantly lower MUAC in individuals with SCD • No differences in mean head circumference |
Glew et al., 2003 [29] | Jos, Nigeria | 10–18 years (mean 14 years for males; mean 13 years for females) | 77 | 75 age- and gender-matched controls | Significantly lower weight in individuals with SCD | Significantly lower height in individuals with SCD | Significantly lower BMI in males with SCD; no differences for females | |
VanderJagt et al., 2007 [30] | Jos, Nigeria | 7–35 years (mean 15 years for males; mean 17 years for females) | 102 | 104 healthy age and gender matched controls | Significantly lower weight in individuals with SCD | • Significantly lower mean sitting height in individuals with SCD • Significantly lower standing height in males with SCD (not significantly different for females) | Significantly lower BMI in females with SCD; no differences for males | • Significantly lower FFM in individuals with SCD; no differences in FFM% and fat % • Significantly lower phase angle (measure of overall nutritional status) in individuals with SCD • Significantly lower MUAC and triceps skin fold in females with SCD (not for males) |
Aina et al., 2010 [31] | Lagos, Nigeria | 10–19 years (mean 14 years) | 136 | 136 age- and gender-matched controls | N/A | N/A | N/A | Delayed puberty in males and females with SCD |
Cox et al., 2011 [32] | Dar es Salaam, Tanzania | 6 months-48 years (mean 10 years) | 1041 | 717 HbAA siblings, clinic walk-ins, and referrals | SCD status was significantly associated with underweight; adult males were more likely to be underweight than females | SCD was significantly associated with stunting; adult males were more likely to be stunted than females | SCD was significantly associated with wasting; adult males were more likely to have wasting than females | |
Osei-Yeboah, 2011 [33] | Ghana | 1–12 years (mean 7 years) | 357; phenotype included SS, SC, SD, S Beta thal | 70 HbAA siblings | • Significantly lower weight-for-age in individuals with SCD • Prevalence of malnutrition higher in individuals with SCD (61%) versus controls (29%) • No significant differences in rates of wasting (weight-for-height) | Prevalence of stunting higher in individuals with SCD (35%) versus controls (3%) | N/A | |
Iwalokun et al., 2011 [34] | Lagos, Nigeria | 5–35 years | 55 (31 steady-state and 24 unstable/ crisis) | 22 “non-SCD” individuals | Significantly lower weight for males > 16 years; not different in other age groups | N/A | Significantly lower BMI in females with SCD (all age groups) and males with SCD (> 16 years) | • Significantly lower fat mass in males with SCD (> 16 years); not significantly different for other age groups • Significantly lower leptin levels in males with SCD (≤16 years) and all female age groups |
Animasahun et al., 2011 [35] | Lagos, Nigeria | 1–10 years (mean 6 years) | 100 | 100 individuals with phenotype HbAA matched by age, socio-economic class, and gender | Significantly lower mean weight and weight-for-height in individuals with SCD | Mean height showed no difference between SCD patients and controls | No difference in mean BMI | |
Akodu et al., 2012 [36] | Lagos, Nigeria | 2–15 years (mean 8 years) | 80 | 80 individuals with phenotype HbAA | No statistical difference reported | N/A | Significantly lower BMI in individuals with SCD | |
Tebbani et al., 2014 [37] | Annaba city, Algeria | 6–12 years | 30 | WHO standard references | Lower weight in individuals with SCD compared with WHO standards | Height was below WHO standard references for SCD patients | N/A | |
Akingbola et al., 2014 [38] | Ibadan, Oyo, Nigeria and Chicago, USA | 11–30 years | 214 | 209 individuals with SCD aged 11–30 years living in USA (compares characteristics of individuals with SCD in Nigeria to those in US) | Significantly lower weight in individuals with SCD in Nigeria vs US in patients ≥18 years old | Significantly lower height in individuals with SCD in Nigeria vs US in patients ≥18 years old | Significantly lower BMI in individuals with SCD in Nigeria vs US in patients ≥18 years old | |
Akodu et al., 2014 [39] | Lagos, Nigeria | 8 months-15 years (mean 6 years) | 100 | 100 HbAA age- and sex-matched controls | N/A | Significantly lower sitting height in individuals with SCD aged > 10 years; height not significantly different | N/A | Significantly shorter arm span in individuals with SCD aged > 10 years |
Tsang et al., 2014 [40] | Nyanza Province, Western Kenya | 6–35 months | 14 | 288 children from random sample of 882; Underweight, stunting and wasting were defined using WHO 2006 standards | No significant association of HbSS with underweight | No significant association of HbSS with stunting | No significant association of HbSS with wasting | |
Eke et al., 2015 [41] | Enugu, Nigeria | 6–18 years (mean 11 years) | 132 | 132 age- and gender-matched HbAA children and adolescents from nearby schools | Significantly lower weight in females with SCD aged 10–18 years; no differences in males | No differences | Significantly lower BMI in females with SCD aged 10–18 years; no differences in males | • No differences in body fat % or visceral fat % • Significantly lower skeletal muscle % in males with SCD aged 6–9 years |
Eke et al., 2015 [42] | Enugu, Nigeria | 1–5 years (mean 3 years) | 58 | 58 age- and gender-matched HbAA individuals | • Significantly lower weight-for-age in individuals with SCD • Significantly lower rate of obesity in individuals with SCD (3.4% vs 22.4%) | No difference in height-for-age | Significantly lower BMI in individuals with SCD | • Significantly lower weight-for-height in individuals with SCD |
Ranque et al., 2016 [43] | Cameroon, Ivory Coast, Gabon, Mali, Senegal | 10–24 years (median 16 years) | 3627 | 943 controls aged 14–33 years; controls were significantly older (median age 24 years versus 16 years for SCD patients) and more likely to be female (60% vs 54%) | N/A | Significantly lower height in individuals with SCD | Significantly lower BMI in individuals with SCD | |
Odetunde et al., 2016 [44] | Enugu State, Nigeria | 6–20 years (mean 12 years) | 40 | 40 age-, gender-, socioeconomic status-matched HbAA individuals from area schools | Significantly lower weight in individuals with SCD | No differences in height | 48% with SCD were underweight (BMI < 5th percentile); 13% of controls were underweight | |
Esezobor et al., 2016 [45] | Lagos, Nigeria | 2–17 years (mean 9 years) | 233 | Compared with WHO 2007 standards | 23% of individuals with SCD had wasting (low weight-for-height) or severe wasting | 12% of SCD patients were stunted or severely stunted; 75.5% were normal height | 2% of individuals with SCD were overweight or obese | |
Senbanjo et al. 2016 [46] | Lagos, Nigeria | Children up to age 15 years (mean 7 years) | 118 (114 HbSS and 4 HbSC phenotype) | 118 age-, gender-, and socioeconomic class-matched; stunting/malnutrition based on WHO 1995 standards | Significantly higher rate of “thinning” in individuals with SCD aged 11–15 years | Significantly higher rate of stunting in individuals with SCD aged 11–15 years | N/A | No overall difference in mean head circumference |
Oluwole et al., 2016 [47] | Lagos, Nigeria | 6–16 years (mean 9 years) | 56 | 44 individuals without SCD | Significantly lower weight-for-age in individuals with SCD | Significantly lower height in individuals with SCD | Significantly lower BMI in individuals with SCD | |
Adegoke et al., 2017 [48] | Ilesa, Nigeria | 4–11 years | 95 | 109 Brazilian children with SCD aged 4–11 years; 36 were hydroxyurea (HU)-naive to match Nigerian patients (study compares SCD populations in Nigeria and Brazil) | 30% of SCD patients in Nigeria had low weight-for-height; 4.3% were overweight or obese | 13% of SCD patients in Nigeria were of short stature; 8.4% were tall for age; significantly lower mean height-for-age among Nigerian patients compared with Brazilian HU-naive patients | Significantly lower BMI in Nigerian individuals with SCD | Significantly lower triceps skin fold, upper arm area, upper arm muscle area, and fat % among Nigerian patients compared with the Brazilian HU-naive patients |
Mikobi et al., 2017 [49] | Kinshasa, Democratic Republic of Congo | Mean 25 years | 140 | Study compared groups of SCD patients stratified by disease severity | N/A | N/A | Significantly lower BMI in patients with greater disease severity | |
Kazadi et al., 2017 [50] | Kinshasa, Democratic Republic of Congo | Under 12 years | 159 | 296 age-, gender-, and neighborhood-matched individuals with HbAA; comparisons focused on children under age 12 years; underweight, stunting and wasting were defined using WHO 2006 standards | Significantly lower weight in individuals with SCD (39.6% of individuals with SCD versus 12.2% of controls) | Significantly more stunting in individuals with SCD (34.6% in individuals with SCD versus 9.8% of controls) | N/A | Factors significantly associated (P < 0.01) with poor growth included frequency of crises, age < 1 yr. at first transfusion, and hand-foot syndrome |
Sokunbi et al., 2017 [51] | Nigeria | 5–18 years (mean 9 years) | 175 | 175 age-matched HbAA individuals | No statistical difference reported | Significantly lower height in individuals with SCD | No statistical difference reported | |
Onukwuli et al., 2018 [52] | Enugu, Nigeria | 6–18 years (females only) | 81 (females only) | 81 age- and socioeconomic class-matched HbAA individuals recruited from outpatient clinic | Significantly lower mean weight in individuals with SCD | No differences in mean height | Significantly lower BMI in individuals with SCD | |
Osei et al., 2019 [53] | Kumasi, Ghana | 3–12 years | 100; phenotypes included SS, Sβ0, SC, Sβ+ | Compared with WHO growth standards | 37% of individuals with were underweight | 22% of individuals with SCD were stunted | ||
Sap Ngo Um et al., 2019 [54] | Yaoundé, Cameroon | 2–5 years | 77 | Compared with WHO growth standards | 4% of subjects were underweight and 5% of subjects were wasted | 4% of subjects were stunted | Trend towards higher rates of underweight, wasting, and stunting with increasing age | |
Alexandre-Heymann et al., 2019 [55] | Cameroon, Ivory Coast, Gabon, Mali, Senegal | 5–21 years | 2583; phenotypes included SS, Sβ0, SC, Sβ+ | 287 HbAA or HbAS individuals | See “other assessments” | See “other assessments” | See “other assessments” | • The primary outcome of “growth failure” was defined as a height and/or weight and/or BMI below the 5th percentile on WHO 2007 growth charts. • Signifcantly higher rates of growth failure found in individuals with SS and Sβ0 phenotypes • Growth failure not found to be correlated with history of SCD-related medical complications • Differences in growth failure rates most pronounced in males aged 15–17 years |
Arigliani et al., 2019 [56] | Kaduna, Nigeria | 6–18 years | 154 | 364 age-matched controls | Significantly increased rate of wasting in individuals with SCD | Significantly increased rate of stunting in individuals with SCD | ||
Arigliani et al., 2019 [57] | Kinshasa, Democratic Republic of Congo | 6–18 years | 112 | 377 schoolchildren controls | Significantly increased rate of wasting in individuals with SCD | Significantly increased rate of stunting in individuals with SCD | ||
Ukoha et al., 2020 [58] | Enugu, Nigeria | 1–18 years | 175 | 175 age-, gender-, and socioeconomic status-matched HbAA individuals | Significantly lower Z-score for weight-for-age in individuals with SCD, and significantly higher rate of wasting in individuals with SCD (using WHO growth references) | Significantly lower Z-score for height-for-age in individuals with SCD, and significantly higher rate of stunting in individuals with SCD (using WHO growth references) | Significantly lower Z-score for BMI-for-age in individuals with SCD |