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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Nutritional status, hospitalization and mortality among patients with sickle cell anemia in Tanzania
Haematologica, Volume 96, No. 7, Year 2011
Notification
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Description
Background: Reduced growth is common in children with sickle cell anemia, but few data exist on associations with long-term clinical course. Our objective was to determine the prevalence of malnutrition at enrolment into a hospital-based cohort and whether poor nutritional status predicted morbidity and mortality within an urban cohort of Tanzanian sickle cell anemia patients. Design and Methods: Anthropometry was conducted at enrolment into the sickle cell anemia cohort (n=1,618; ages 0.5-48 years) and in controls who attended screening (siblings, walk-ins and referrals) but who were found not to have sickle cell anemia (n=717; ages 0.5-64 years). Prospective surveillance recorded hospitalization at Muhimbili National Hospital and mortality between March 2004 and September 2009. Results: Sickle cell anemia was associated with stunting (OR=1.92, P<0.001, 36.2%) and wasting (OR=1.66, P=0.002, 18.4%). The greatest growth deficits were observed in adolescents and in boys. Independent of age and sex, lower hemoglobin concentration was associated with increased odds of malnutrition in sickle cell patients. Of the 1,041 sickle cell anemia patients with a body mass index z-score at enrolment, 92% were followed up until September 2009 (n=908) or death (n=50). Body mass index and weight-for-age z-score predicted hospitalization (hazard ratio [HZR]=0.90, P=0.04 and HZR=0.88, P=0.02) but height-for-age z-score did not (HZR=0.93, NS). The mortality rate of 2.5 per 100 person-years was not associated with any of the anthropometric measures. Conclusions: In this non-birth-cohort of sickle cell anemia with significant associated undernutrition, wasting predicted an increased risk of hospital admission. Targeted nutritional interventions should prioritize treatment and prevention of wasting. © 2011 Ferrata Storti Foundation.
Authors & Co-Authors
Cox, Sharon E.
United Kingdom, London
Medical Research Council
Tanzania, Dar es Salaam
Muhimbili University of Health and Allied Sciences
Makani, Julie B.
Tanzania, Dar es Salaam
Muhimbili University of Health and Allied Sciences
United Kingdom, Oxford
Nuffield Department of Medicine
Fulford, Anthony J.C.
United Kingdom, London
Medical Research Council
Komba, Albert N.
Tanzania, Dar es Salaam
Muhimbili University of Health and Allied Sciences
Soka, Deogratias
Tanzania, Dar es Salaam
Muhimbili University of Health and Allied Sciences
Williams, Thomas Neil
United Kingdom, Oxford
Nuffield Department of Medicine
Kenya, Kilifi
Centre for Geographic Medicine Research
Newton, Charles R.J.C.
United Kingdom, London
Medical Research Council
Tanzania, Dar es Salaam
Muhimbili University of Health and Allied Sciences
Kenya, Kilifi
Centre for Geographic Medicine Research
United Kingdom, London
Ucl Great Ormond Street Institute of Child Health
Marsh, Kevin
United Kingdom, Oxford
Nuffield Department of Medicine
Kenya, Kilifi
Centre for Geographic Medicine Research
Prentice, Andrew M.
United Kingdom, London
Medical Research Council
Statistics
Citations: 62
Authors: 9
Affiliations: 5
Identifiers
Doi:
10.3324/haematol.2010.028167
ISSN:
03906078
e-ISSN:
15928721
Research Areas
Environmental
Food Security
Health System And Policy
Maternal And Child Health
Study Design
Cross Sectional Study
Cohort Study
Study Locations
Tanzania
Participants Gender
Male