Development of disease-specific growth curves from Kenyan children with sickle cell anemia Open Access

• The lack of appropriate reference growth curves for children in Africa living with SCA impedes assessment of effects of therapy on growth.

• Our new growth curves, based on a Kenyan cohort with SCA , will provide useful disease-specific references for clinicians and researchers.

Sickle cell anemia (SCA) is a life-threatening hemoglobinopathy with worldwide distribution. Featuring multiple acute and chronic complications, SCA is also associated with growth impairment. Assessing the impact of therapies on growth in African children with SCA is impeded by lack of appropriate reference data on height, weight, and body mass index (BMI). World Health Organization (WHO) growth curves derive from healthy populations and are not disease-specific. We analyzed 6095 height and weight pairs (2875 females, 3220 males; median 5 measurements/child) from 864 SCA youth, 0.5 to 19 years in Kilifi, Kenya. The growth centile trajectories document substantial delays compared to WHO curves. Female deficits in median height were 7cm at age 5, 11cm at 10, and 13cm at age 15 years; male height deficits were 6cm at age 5, 10cm at 10, and 21cm at age 15 years. Female median weight deficits were 3.4kg at age 5 and 9.1kg at age 10 years, and for males 3.0kg at age 5 and 7.7kg at age 10 years. Median BMI was lower by 5 kg/m² at age 15 years for both females and males. These newly developed Kilifi SCA growth curves provide useful disease-specific references for clinicians and researchers.