Peer-reviewed article
Early Body Mass Index z ‐Score Change and Resolution of Severe Malnutrition in Children With Sickle Cell Anemia in a Low‐Income Setting: A Prospective Single‐Arm Extension Study
Safiya Gambo, Shehu Umar Abdullahi, Hassan Adam Murtala, Halima Kabir, Khadija A. Shamsu et al. ·
Summary
Written by AI, not yet AICS's view · claude-sonnet-5This study looked at children in Nigeria with sickle cell anemia who still had severe malnutrition after initial feeding treatment. Researchers gave them a more intensive therapeutic food regimen along with a medicine called hydroxyurea for up to 24 weeks. Nearly half of the children recovered from severe malnutrition by the end of the study. Children who showed early improvement in their weight measurements after just 4 weeks were much more likely to fully recover later, while older children were less likely to recover.
Key points
- 108 children with sickle cell anemia and severe malnutrition were studied; 66 continued into an extended 24-week treatment phase.
- By Week 12, 39% of children had resolved their severe malnutrition; by Week 24 this rose to 49%.
- Children whose weight status improved early (by Week 4) had much higher odds of later recovery (OR 12.38).
- Older children had lower odds of recovering from severe malnutrition (OR 0.72).
- The authors say this early signal should be tested further before changing clinical practice.
Limitations
This was a small study with no comparison group, so it cannot prove the treatment itself caused the improvements; results may not apply to all settings or age groups.
Abstract
BACKGROUND: Children with sickle cell anemia (SCA) in low-income settings are at risk of severe malnutrition, but optimal nutritional management has not been established. We evaluated an intensified ready-to-use therapeutic food (RUTF) regimen in children with persistent severe malnutrition after initial treatment and assessed whether early change in body mass index z-score (BMIZ) was prognostic of later resolution of severe malnutrition. PROCEDURE: Children aged 5-12 years with SCA and BMIZ less than -3.0 after 12 weeks of supplemental RUTF received higher intensity, weight-based RUTF plus hydroxyurea through Week 24. We examined whether the change in BMIZ from baseline to Week 4 was associated with the resolution of severe malnutrition (BMIZ ≥-3.0) by Week 12 or, among extension participants, by Week 24. RESULTS: Of 108 children, 66 (61%) entered the extension. During Weeks 12-24, 11 of 66 (17%) achieved resolution, increasing the cumulative proportion with BMIZ ≥-3.0 from 39% (42/108) at Week 12 to 49% (53/108) by Week 24. Greater improvement in BMIZ from baseline to Week 4 was associated with higher odds of resolution by Week 12 or, among extension participants, by Week 24 (OR 12.38; p < 0.001), whereas older age was associated with lower odds of resolution (OR 0.72; p = 0.006). Among extension participants, higher Week-12 BMIZ was associated with higher odds of Week-24 resolution (OR 14.44; p = 0.039). CONCLUSIONS: In children with SCA and severe malnutrition, early BMIZ improvement in this small, single-arm extension was associated with later resolution of severe malnutrition, and may help risk-stratify children who need earlier reassessment or alternative management, a prognostic signal that warrants prospective testing rather than an immediate change in practice.
Findings the Hub has extracted
Each claim below is labelled by its type of design and links back to this report.
- Intervention
- Higher-intensity, weight-based ready-to-use therapeutic food (RUTF) combined with hydroxyurea medication
- Population
- Children aged 5-12 years with sickle cell anemia and severe malnutrition (BMI z-score below -3.0) after 12 weeks of initial RUTF treatment
Key finding
49% (53/108) of children had resolved severe malnutrition by Week 24, up from 39% at Week 12
Gambo et al. · OpenAlex · 17 Sept 2026