SERUM ZINC STATUS IN SICKLE CELL ANAEMIA PATIENTS AT THE JOS UNIVERSITY TEACHING HOSPITAL, JOS, NIGERIA

Abstract

This was a case control study carried out at the Paediatric Outpatient Clinic of
the Jos University Teaching Hospital, Jos, Nigeria to determine the serum zinc
concentration in patients aged 1 to 18 years with sickle cell anaemia (SCA), the
relationship between serum zinc concentration and anthropometric indices and
the socio-economic status of the patients.
Seven hundred children (350 sickle cell anaemia patients and 350 age and sex
matched controls) were recruited into the study.
The mean weight of the controls (29.13±13.86kg) was higher than the
subjects (24.51±11.64kg), and the mean height of the subjects was lower
than the controls (121.97±25.30cm Vs 131.08±23.88cm), the differences
were significant (p<0.0001).
The mean serum zinc concentration of children with sickle cell anaemia was
6.22±2.81µol/l which was significantly lower than that of the controls at
8.70±2.23µmol/l (p<0.001). The serum protein was lower in the subjects
compared with controls, and the difference is significant (p<0.0001), but
there was no significant difference in albumin levels between the two groups
(42.27±3.84 Vs 42.38±4.75g/dl; p=0.75). The packed cell volume of
patients with sickle cell anaemia was significantly lower than in the controls
(27.5 Vs 32.1%; p<0.0001).
The prevalence of zinc deficiency(less than 7.65µmol/l) in this study was
67% in children with sickle cell anaemia compared with 34% in the control
group, and this was significant(p<0.0001).
When the study population were stratified into different age groups, there
were more children in the age group 1 to 10 yrs that were zinc deficient
compared with the older age group, the difference is significant(p<0.0001).
There was an indirect association between serum zinc levels and the socio
economic status in both the subjects and controls. One-third (111) of the
subjects in the lower social class were zinc deficient compared with 50
children in the upper class (p<0.0001). This is also true for the controls, 51
children in the lower class were zinc deficient compared with 29 children in
the upper class (p<0.0001).
The height for age, weight for age and weight for height Z-scores were lower
in the subjects compared with controls and the difference was
significant(p<0.05). Malnutrition (wasting, underweight and stunting) was
more prevalent among the SCA group compared with the controls. There
was a direct relationship between zinc deficiency and anthropometric indices
in the study population. Among the subjects, 69% children who were wasted
also had zinc deficiency compared with 33% among the controls (p<0.0001).
The relationship between serum zinc and stunting also showed a direct
association. Twenty nine percent of the subjects who were stunted also had
zinc deficiency compared with 9% of the controls (p<0.0001).
The addition of zinc to the routine medications of children with sickle cell
anaemia may help to reduce the high prevalence of zinc deficiency and the
morbidity and mortality associated with this disease.

SERUM ZINC STATUS IN SICKLE CELL ANAEMIA PATIENTS AT THE JOS UNIVERSITY TEACHING HOSPITAL, JOS, NIGERIA