Aim To study growth pattern of children with sickle cell disease as growth deficit experienced by these children remain a problem with clinical significance and intangible consequence.
Method Retrospective cross sectional growth pattern review of children with SCD in a large district general hospital. Confounding factors like Penicillin V prophylaxis, up-to-date immunisation, vitamin supplement, regular health education and nutritional advice were taken into consideration.
Results Total of 28 children with SCD was registered and two third of them were girls. Age ranges was between 14 months to 16 years. Most of them are homozygous (85%) sickle cell disease. The rest were HbSC (2 patient) and Sickle thalassaemia (2 patient).
There was wide range of growth pattern with 86% of patients (24 patients) were between 9th to 91st centile for weight and 78% (22 patients) were between 9th to 91stcentile for height. Only two children had growth failure with weight between 0.4–2nd centile and height on 0.4th centile but both of them were ex-preterm. One patient was obese with weight and height over 99th centile.
All children were on prophylactic antibiotics, daily vitamin supplements and up-to-date with immunisation including annual influenza vaccine. Twenty six of 28 children above 2 years of age received regular pneumococcal vaccine. In 2013, nearly half of them (42%) needed hospital admissions (1–11 admissions) for SCD related problems. Four children were on hydrocarbamide treatment but their growth parameters were not different to others. Only 2 children had input from dietician because they were pre-term babies.
Conclusions Numerous studies have demonstrated poor growth in SCD patients and its aetiology is multi-factorial. In comparison, most of our children with Sickle cell disease were growing well within the normal range with appropriate clinical care.
It is imperative that general paediatricans in district general hospital are familiar with growth pattern in chronic haematological condition like sickle cell disease. It is important to recognise their role in clinical practice to provide advice on penicillin prophylaxis, immunisation and nutrition and parent education on preventing crisis in sickle cell disease to optimise growth and improve health outcome.
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