Skeletal maturity of the hand in an East African group from Sudan

Objectives: Studies of skeletal maturity from Africa indicate a delay, reflected in a negative relative skeletal age (RSA). This study aims to evaluate the influence of age, socioeconomic status (SES) and nutritional status on skeletal maturation in a large sample of children from North Sudan. Materials: The sample consisted 665 males and 1018 females from 3-25 years from Khartoum. Height, weight, age of menarche and, SES were recorded of patients attending for dental treatment. Methods: Skeletal age was assigned from hand-wrist radiographs using the Greulich-Pyle (GP) atlas (1952). RSA (difference between skeletal and chronological ages) was compared in groups divided by age, sex, height-for-age and body-mass-index z scores, and SES. Spearman's correlation and student t-test was used to compare groups. Results: Delayed skeletal age was noted across all age in boys. In girls, a delay was observed between ages 6-10, while advancement occurred between ages 13–18. Maturity was delayed in low height groups (p <.05) and low SES groups. RSA was negatively associated with HAZ in low SES males (R = −0.0.27, p <.001) and low SES females (R = −0.32, p <.001). Conclusions: There were statistically significant skeletal delays in North Sudanese males and most pre-menarche females, low height and low SES groups. Post-menarche females were advanced relative to males and GP references. Low SES impacts were statistically correlated to skeletal delay.