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Licensed Unlicensed Requires Authentication Published by De Gruyter July 19, 2021

The effect of sickle cell anemia on the linear growth of Nigerian children

Ugo Nnenna Chikani ORCID logo, Adaobi Bisi-Onyemaechi, Ijeoma Ohuche, Justus Onu ORCID logo, Shalewa Ugege, Chinwe Ogugua, Ngozi Mbanefo, Paschal Chime and Ifeoma Emodi



Despite the high prevalence of children with sickle cell anaemia (SCA) in West Africa, there is paucity of data on the height velocity and prevalence of growth failure in SCA patients. With advances in clinical care of SCA patients, could there be a spatial and secular trend in the growth pattern of these children? Hence, the compelling needs to embark on this study. The objectives of the study were to determine the prevalence of growth failure among patients with SCA and its correlation with age, gender and age at diagnosis.


A Prospective longitudinal study of a cohort of sickle cell anaemic paediatric patients from Pediatrics SCA Clinic, University of Nigeria Teaching Hospital, Ituku Ozalla. Patients were enrolled over a period of two years using a non-parametric convenient sampling method. Their heights were measured at baseline, three months, six months and at 12 months intervals and subsequently plotted on a standard WHO growth chart. The height velocities at different monthly intervals were calculated and compared with the WHO standard normal linear growth rates) for children (used as control) to identify those with GF. (i.e. <10th percentile). The main outcome measures were the mean height velocities at different months' intervals calculated and compared using the repeated measurement analysis of variance (ANOVA) and the Wilcoxon signed test.


A cohort of 316 children aged 1–18 years with SCA was evaluated with a male preponderance of 161 (57.4%). The mean age and age at diagnosis were 11.04 ± 5.56 and 4.2 ± 1.7 years, respectively. The prevalence of growth failure and short stature was 84.7%. The burden of GF was highest among post-pubertal participants (94.1%). The most important predictor of growth velocity deficit was age (R2=0.045, standard β coefficient = −0.22, t=−03.51, p=0.001).


The study demonstrated high prevalence of growth failure in children and adolescents with SCA which intensified with advancement in age and older age at diagnosis.

Corresponding author: Dr Ugo Nnenna Chikani, MBBS, FMC Paed, FESPE, Senior Lecturer/Paediatric Endocrinologist, Department of Paediatrics, University of Nigeria Ituku Ozalla Campus, PMB 01129, Enugu 40001, Nigeria, E-mail:


I wish to thank the Almighty God, my mentor Prof Alan Rogol for reviewing the earlier version of the manuscript, and all participants/caregivers for immense help and cooperation.

  1. Research funding: None declared.

  2. Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.

  3. Competing interests: Authors state no conflict of interest.

  4. Informed consent: Written informed consent was obtained from parents/caregivers of participating children and assent from children older than or equal to seven years.

  5. Ethical approval: The Health and Ethics and Research Committee of the University of Nigeria Teaching Hospital approved the study.


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Received: 2021-03-31
Accepted: 2021-06-20
Published Online: 2021-07-19
Published in Print: 2021-10-26

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