Abstract
Introduction Sickle cell disease (SCD) is the most common monogenic disorder in India and globally, contributing to non-communicable death and child mortality. The prevalence of sickle gene carrier states can be as high as 40 % in certain states. The Arab Indian haplotype is the most common in India. Malnutrition is prevalent in SCD patients. Malnutrition has a significant impact on SCD patients and impairs their quality of life. This study aimed to analyze a large cohort from a geographical tribal location encompassing all diagnosed subjects.
Methods. This was a prospective, observational study. A total of 1337 individuals with SCD, who were registered as sickle patients, were analyzed. The weight of the children was recorded on an electronic weighing machine, and their height was recorded on a stadiometer. The BMI was used to define weight categories as follows: Underweight (BMI < 18.5 kg/m²), normal weight (BMI = 18.5 kg/m² - 24.9 kg/m²), overweight (BMI = 25 kg/m² - 29.9 kg/m²), and obese (BMI ≥ 30 kg/m²).
Results. Detailed data from 1337 patients were collected through their visits to outpatients or through local healthcare workers. The study group included 709 men (53.0%) and 628 women (47.0%). Only 30 (2.24%) were below two years of age, 70 (5.24%) were between 2 and 5 years, 340 (25.43%) were 5-12 years, 331 (24.76%) were 12-18 years, 78 (5.83%) were 18-20 years, 145 (10.85%) were 20-25 years, 143 (10.70%) were 25-30 years, and 200 (14.96%) were above 30 years. Overall, 671 (50.19%) patients were between 5 and 18 years of age. BMI analysis revealed 762 (57%) were underweight with a BMI of less than 18.5 (median 15.548, IQR 13.587-17.191). In the normal weight group there were 452 (33.8%) patients with a median BMI of 20.387 (IQR 19.375-22.058). The overweight group included 81 (6.1%) patients with a median BMI of 26.910 (IQR 26.262-29.081), and 42 (3.1%) were obese with a median BMI of 33.632 (IQR 32.291-39.983).
Discussion This analysis reports a very large cohort that has never been reported to date in this part of the world. It encompasses a unique tribal territory with no migratory patients included and practically every individual suffering from SCD in this area. This makes the study important, as the data can be extrapolated to a larger population. A large percentage appeared to be underweight. This may open doors for deeper study and running nutritional programs directed towards SCD patients. A Z-score analysis is underway and may offer deeper insights.
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