Sickle cell trait (HbAS) and stunting in children below two years of age in an area of high malaria transmission
2009

Sickle Cell Trait and Stunting in Young Children

Sample size: 1070 publication Evidence: moderate

Author Information

Author(s): Kreuels Benno, Ehrhardt Stephan, Kreuzberg Christina, Adjei Samuel, Kobbe Robin, Burchard Gerd D, Ehmen Christa, Ayim Matilda, Adjei Ohene, May Jürgen

Primary Institution: University Medical Centre Hamburg-Eppendorf, Hamburg, Germany

Hypothesis

In areas with high malaria transmission, HbAS may, through protection against malaria, also confer protection against stunting in young children.

Conclusion

Young children with sickle cell trait (HbAS) have a lower risk of stunting in an area with high malaria transmission, most likely mediated through protection against mild malaria.

Supporting Evidence

  • Carriers of the HbAS genotype had a 58% decreased risk of being stunted at two years of age compared to HbAA carriers.
  • The protective effect of HbAS on stunting was significant only in children who experienced malaria episodes.
  • At recruitment, 4% of children were stunted, which increased to 20% by the end of the follow-up period.

Takeaway

Kids with sickle cell trait are less likely to be short for their age if they live in places with a lot of malaria, probably because the trait helps protect them from getting sick.

Methodology

1,070 children were recruited at three months of age and followed-up for 21 months with anthropometric measurements performed every three months.

Potential Biases

Minimal bias due to loss of only 19 children to follow-up.

Limitations

Follow-up bias due to the restriction of the analysis to children who were available for six anthropometric measurements.

Participant Demographics

Children from the Ashanti Region, Ghana, aged three months to two years.

Statistical Information

P-Value

0.034

Confidence Interval

0.33–0.96

Statistical Significance

p<0.05

Digital Object Identifier (DOI)

10.1186/1475-2875-8-16

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