Prevalence of undernutrition and its associated factors among children with sickle cell disease aged 6-59 months at Mulago National Referral Hospital Kampala, Uganda.

Abstract

Introduction: Sickle cell disease (SCD) significantly contributes to under-five morbidity and mortality in sub-Saharan Africa and increases vulnerability to undernutrition. However, limited studies exist on the prevalence of undernutrition and its associated factors among children under five years with SCD in Uganda. Objective: To assess the prevalence of undernutrition and its associated factors among children with SCD aged 6-59 months attending the sickle cell clinic at Mulago National Referral Hospital in Kampala, Uganda. Methods: A facility-based cross-sectional study was conducted among 329 children aged 6-59 months. Data was collected using a structured questionnaire and analyzed using STATA 14. Modified Poisson regression used to identify the factors associated with undernutrition. Results: The prevalence of undernutrition among children with SCD aged 6-59 months was 31.3% (n=103), with 27.4% (n=90) stunted and 14.3% (n=47) underweight. Undernutrition among children with SCD was statistically significantly associated with child below 24 months but not breastfeeding (aPR=1.27; 95% CI: 1.09-1.48; P-0.002), not immunized against measles (aPR=1.31; 95% CI: 1.02-1.68; P-0.03), and child not taking hydroxyurea drug (aPR=1.5; 95% CI: 1.07-2.08; P-0.017). Conclusion and recommendations: The prevalence of undernutrition among children aged 6-59 months with SCD at Mulago National Referral Hospital was high (31.3%) compared to the WHO cut off values of undernutrition. In this study, the prevalence of stunting (27.4%) and underweight (14.3%) was higher than the national prevalence of stunting (25%) and underweight (7.8%) as reported in the Uganda National Panel Survey of 2019/20. The factors associated with undernutrition were early weaning of children, not being immunized against measles and the child not taking hydroxyurea drug. There is need for sensitization of the public about the benefits of breastfeeding children till 24 months of age, immunization and hydroxyurea drug among SCD children; and integrating hydroxyurea drug in the standard care package of management of SCD in Uganda.