Prevention of Malnutrition in Children With Sickle Cell Disease

Prevention of Malnutrition in Children With Sickle Cell Disease Living in Northern Nigeria

The investigators are studying how to prevent malnutrition in children with sickle cell disease (SCD) in northern Nigeria. Community health workers will teach mothers about nutritious local foods that might help children grow better than the usual advice from doctors. The investigators will enroll 148 children with SCD aged 6 to 18 months old. The investigators will determine if their weight and diet improve and check for low vitamin A levels. This information will help us find better ways to improve growth for children with SCD.

Despite efforts to improve nutrition, 45% of under-5 mortality is at least partially attributable to malnutrition. Children with SCD have high nutrient demands and energy expenditures with a risk of impaired growth. The investigators will test the hypothesis that maternal nutrition education on locally available nutrient-dense foods will lead to improved childhood growth compared to standard pediatrician-delivered nutrition counseling. The research will involve a randomized controlled trial with 148 children aged 6 to 18 months with SCD, assessing changes in weight-for-age z-scores and dietary adequacy, as well as determining the prevalence of vitamin A deficiency. These preliminary findings will inform evidence-based interventions for the primary prevention of malnutrition (underweight and vitamin A deficiency) in children with SCD.

Inclusion Criteria:

• laboratory confirmed SCD (HbSS, HbSβ0 thalassemia, or HbSC)
• aged 6 to 18 months.

Exclusion Criteria:

• severe acute malnutrition (weight-for-length z-score <-3 or mid-upper arm circumference <11.5 cm)
• diagnosis of HIV or other chronic illnesses