Nutritional perspectives on sickle cell disease in Africa: a systematic review

BMC Nutrition

Hyacinth I. Hyacinth¹  Amma Benneh-Akwasi Kuma²  Alice Koryo-Dabrah³  Matilda Steiner-Asiedu⁴  Agartha Ohemeng⁴  Seth Adu-Afarwuah⁴  Eunice Berko Nartey⁵  Alan Jackson⁶  Rajiv Shah⁷  Jonathan Spector⁸  Catherine L. Jones⁹ 

[1] Aflac Cancer and Blood Disorder Center of Children’s Healthcare of Atlanta and Emory University Department of Pediatrics, Atlanta, GA, USA;The Atlanta Sickle Cell Disease Consortium, Atlanta, USA;Department of Hematology, School of Medicine and Surgery, University of Ghana, Korle-Bu, Ghana;Department of Nutrition and Dietetics, University of Health and Allied Sciences, PMB 31, Ho, V/R, Ghana;Department of Nutrition and Food Science, University of Ghana, Legon, Ghana;Department of Nutrition and Food Science, University of Ghana, Legon, Ghana;Department of Nutrition and Dietetics, University of Health and Allied Sciences, PMB 31, Ho, V/R, Ghana;Emeritus Professor of Human Nutrition, Southampton General Hospital (MP 113), Tremona Road, SO16 6YD, Southampton, UK;Novartis Global Health and Corporate Responsibility, Forum 1, Fabrikstrasse, Basel, Switzerland;Novartis Institute for Tropical Diseases, Cambridge, USA;Novartis Institute for Tropical Diseases, Emeryville, CA, USA;

关键词: Nutritional status;    Malnutrition;    Sickle cell disease;    Sickle cell anemia;    Systematic review;   

DOI  :  10.1186/s40795-021-00410-w

来源: Springer

【 摘 要 】

BackgroundSickle cell disease (SCD) is an inherited blood disorder that predominantly affects individuals in sub-Saharan Africa. However, research that elucidates links between SCD pathophysiology and nutritional status in African patients is lacking. This systematic review aimed to assess the landscape of studies in sub-Saharan Africa that focused on nutritional aspects of SCD, and highlights gaps in knowledge that could inform priority-setting for future research.MethodsThe study was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. Inclusion criteria comprised original, peer-reviewed research published between January 1995 and November 2020 involving individuals in Africa with any phenotypic variant of SCD and at least one nutritional status outcome. Nutritional status outcomes were defined as those that assessed dietary intakes, growth/anthropometry, or nutritional biomarkers. Databases used were Ovid Embase, Medline, Biosis and Web of Science.ResultsThe search returned 526 articles, of which 76 were included in the final analyses. Most investigations (67%) were conducted in Nigeria. Studies were categorized into one of three main categories: descriptive studies of anthropometric characteristics (49%), descriptive studies of macro- or micronutrient status (41%), and interventional studies (11%). Findings consistently included growth impairment, especially among children and adolescents from sub-Saharan Africa. Studies assessing macro- and micronutrients generally had small sample sizes and were exploratory in nature. Only four randomized trials were identified, which measured the impact of lime juice, long-chain fatty acids supplementation, ready-to-use supplementary food (RUSF), and oral arginine on health outcomes.ConclusionsThe findings reveal a moderate number of descriptive studies, most with small sample sizes, that focused on various aspects of nutrition and SCD in African patients. There was a stark dearth of interventional studies that could be used to inform evidence-based changes in clinical practice. Findings from the investigations were generally consistent with data from other regional settings, describing a significant risk of growth faltering and malnutrition among individuals with SCD. There is an unmet need for clinical research to better understand the potential benefits of nutrition-related interventions for patients with SCD in sub-Saharan Africa to promote optimal growth and improve health outcomes.

【 授权许可】

CC BY