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

• The lack of appropriate reference growth curves for children in Africa living with SCA impedes assessment of the effect 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. A lack of appropriate reference data on height, weight, and body mass index (BMI) impedes assessment of the effect of therapies on growth in African children with SCA. The World Health Organization (WHO) growth curves are derived from healthy populations. We analyzed 6095 height and weight paired measurements (2875 in females, 3220 in males; median, 5 measurements/child) from 864 children with SCA, aged 6 months to 19 years, in Kilifi, Kenya. The growth percentile trajectories showed substantial delays when compared with the WHO curves. The female deficits in median height were 7 cm at age 5 years, 11 cm at 10 years, and 13 cm at age 15 years. Male height deficits were 6 cm at 5 years, 10 cm at 10 years, and 21 cm at 15 years. Median weight deficits were 3.4 kg at 5 years and 9.1 kg at 10 years for females, and 3.0 kg at 5 years and 7.7 kg at 10 years for males. The median BMI was lower by 5 kg/m 2 at 15 years for both females and males. These newly developed Kilifi SCA growth curves provide useful disease-specific references for clinicians and researchers.