(P10-054-24) Defining Undernutrition Risk Factors in Young Children With Sickle Cell Disease in Northern Nigeria

Objectives: Children under 5 years old with sickle cell disease (SCD) in northern Nigeria are at a higher risk of both undernutrition and mortality. Severe acute malnutrition is a critical medical emergency. If untreated, it can be as deadly as some of the most severe pediatric diseases.  Despite global efforts to improve nutrition, undernutrition contributes to 45% of all deaths in children under 5. We aimed to identify risk factors associated with undernutrition in children under 5 with SCD in northern Nigeria to inform tailored prevention strategies for this high-risk group.

Methods: We conducted a cross-sectional study at a tertiary-level referral hospital in Kano, northern Nigeria. Children between the ages of 6 and 59 months with laboratory-confirmed SCD were consecutively recruited from the SCD clinic between September 2020 and June 2022. Children with acute illnesses were excluded. Ethical clearance and parental consent were obtained. Demographic and baseline data, including complete blood counts and anthropometry, were collected by the research staff. Wasting and underweight were defined as mid-upper arm circumference (MUAC) < 12.5 cm and weight-for-age z-score < -2.0, respectively.

Results: We enrolled 354 children aged 6-59 months old with SCD. The prevalence of underweight (weight-for-age z-score < -2) was 23.2% (n=82 of 354), while the prevalence of wasting (mid-upper arm circumference < 12.5 cm) was 12.9% (n=45 of 349). In multivariable analysis, lower hemoglobin levels were associated with both underweight (OR=1.52, 95%CI 1.18-1.95, p< 0.001) and wasting (OR=2.01, 95%CI 1.48-2.99, p< 0.001). Female sex was also a risk factor for wasting (OR=2.01, 95%CI 1.04-3.87, p=0.038).

Conclusions: Lower hemoglobin levels are associated with being underweight and wasted in young children with SCD. These findings could inform the development of targeted prevention strategies and interventions for undernutrition, ultimately reducing the burden of morbidity and mortality associated with SCD.

Funding Sources: Fogarty International Center, St. Jude Children’s Research Hospital, and the Katherine Dodd Faculty Scholars Program