Iron status of sickle cell children in Libreville, Gabon: prevalences and associated factors

Abstract

Background: Iron is essential for a child's growth. In the Gabonese general pediatric population, iron deficiency is the most widespread nutrient deficiency. Quid of the sickle cell children in Libreville, Gabon? Methods: We conducted a cross-sectional study including sickle cell children aged from 6 months to 15 years, with haemoglobin SS confirmed. Subjects included were examined in steady-state. Data collected were about the socioeconomic background of the families, medical history of the children. To determine iron status, we used: CRP, Ferritin, serum iron, Transferrin, total blood count cell and erythrocytic parameters. Results: We included 247 children; 128 boys (51.8%) and 119 girls (48.2%). The median age of the children was 8 years [1 year - 15 years]. Following definition criteria we found: 9% (95% CI [18.6% - 29.2%]) of iron deficiency, 67.6% (95% CI [62.2% - 73.8%]) of normal iron status, and 8.1% (95% CI [4.7% - 11.5%]) of iron overload. Iron deficiency was associated with a child’s rank >2, OR=2.1 (95%IC [1.2-6], p<0.001). Iron overload was associated with age >11 years OR=2.5 (95%IC [1.7-9], p<0.001); mothers’ low educational level OR=3.6 (945% IC [1.4-9], p=0.03); transfusion OR=10,5 (95%IC [1,9 – 53], p =.0.025); a last transfusion between 4 and 6 months OR=9.1 (95%IC [3.1-21], p<0.001). Conclusion: The majority of sickle cell children in our context has a normal iron status. Iron deficiency and iron overload should be monitor and treated according to associated factors, and greater studies are required to determine algorithms to assess and treat and iron imbalance.