ASSESSMENT OF PHYSICAL GROWTH AND SEXUAL MATURATION AMONG ADOLESCENTS WITH SICKLE CELL DISEASE AGED 10-18 YEARS SEEN AT UNIVERSITY OF BENIN TEACHING HOSPITAL, BENIN CITY

Abstract

Background:
Growth restriction and delayed puberty are well-recognized complications of Sickle cell disease (SCD), particularly in sub-Saharan Africa where disease burden is highest. However, data on determinants of sexual maturation among Nigerian adolescents with SCD remain limited.

Objective:
To assess growth patterns, pubertal development and determinants of sexual maturity among adolescents with SCD compared with age- and sex-matched controls.

Methods:
A cross-sectional comparative study was conducted among 150 adolescents with SCD and 80 healthy controls aged 10–18 years attending University of Benin Teaching Hospital (UBTH), Benin City, Edo State. Anthropometric measurements were obtained and body mass index (BMI) calculated. Height-for-age (HAZ) and BMI-for-age (BAZ) Z-scores were generated using WHO Anthro plus. Pubertal assessment was performed using Tanner staging; testicular volume was measured in males and age at menarche documented in females. Disease severity indices and steady-state packed cell volume (PCV) were recorded. Data were analysed using SPSS version 26.0. Statistical significance was set at p<0.05.

Results:
Adolescents with SCD had significantly lower mean weight, height and BMI compared to controls (p<0.001). Mean HAZ (-1.85) and BAZ (-2.10) indicated significant stunting and wasting. A substantial proportion of those aged 13–15 years remained in Tanner stages II–III. Testicular volumes in males aged 13–18 years were significantly below age-specific norms (p<0.001). Mean age at menarche was significantly delayed (13.9 ± 1.6 years; p<0.001). Disease severity was significantly associated with lower BMI and delayed puberty. In multivariate analysis, age, BMI and steady-state PCV independently predicted advanced Tanner stage.

Conclusion:
Adolescents with SCD exhibit significant growth impairment and delayed sexual maturation. Optimizing nutritional status and haematological control may improve pubertal outcomes.