Beta Thalassemia Major Clinical Trial
Official title:
Anthropometric Measurements in Children Having Transfusion-dependent Beta Thalassemia.
The aim of this study was to determine the anthropometric measurements in transfusion-dependent β-thalassemia children in Pakistan. The secondary aim was to correlate serum ferritin with the physical growth
Material and methods
Setting The study was conducted at the Sections of Hematology and Clinical Chemistry in the
Department of Pathology and Laboratory Medicine, Aga Khan University, Karachi, Pakistan
during January 2013 to December 2014. Patient recruitment was conducted at a non-profit
organization named Fatimid Foundation Karachi (FFK), which provides free of cost blood
components to the patients with various blood disorders. There are more than 4000 registered
patients of thalassemia and hemophilia at FFK.
Patient selection After informed consent from their parents, 367 pediatric patients (age 5-17
year) with transfusion-dependent β-thalassemia were recruited. All patients were diagnosed
based on hemoglobin electrophoresis or high-performance liquid chromatography.
Data collection Detail history was collected by a trained research officer on a predetermined
questionnaire. The following information was collected from medical records of the patients:
demographics (age, gender, age at the time of diagnosis and at first transfusion),
anthropometrics (height and weight), and clinical details (blood transfusion history, iron
chelation, last pre-transfusion hemoglobin, and last serum ferritin levels).
Sample collection Five milliliter of blood samples were collected in two tubes
(ethylenediaminetetraacetic acid and gel) at Fatimid foundation by a trained phlebotomist
prior to blood transfusion to determine hemoglobin and serum ferritin.
Laboratory methodology Serum ferritin was measured by chemi-luminescent micro-particle
immunoassay on Cobos® E-601 and hemoglobin was measured using Sysmex® XP-100.
Anthropometry World health organization (WHO) 2007 growth charts were used for boys and girls
to assess their physical growth. Body mass index (BMI) was computed as weight in kg/height in
square meters. z-Score of height (h-SDS), weight (w-SDS) and BMI. According to WHO reference
2007, a z-score of <−2 for height was considered as stunted growth and BMI of <−2 was
considered as underweight or thin for age.
Statistical analysis Data were collected, managed, edited, entered, and analyzed by
statistical package of social sciences (SPSS) version 22 and STATA 13 (Stata Corp, College
Station, TX, U.S.A.). A descriptive analysis of all patients in the study was performed. In
order to analyze the profile of the sample according to the variables studied, frequency
tables for categorical variables like (gender, age group) were created. Male: female ratio
was also computed. The mean ± standard deviation, minimum and maximum values were calculated
for parametric and median and interquartile range (IQR; Q3-Q1) for non-parametric variables.
Spearman rho correlation was used to test relationships between the non-parametric variables.
The level of significance taken for all the statistical tests was a p-value of <0.05. The
association of h-SDS with median serum ferritin levels was further confirmed by comparing
these laboratory parameters in children with height z-scores <2 with those with the z-score
≥2 using the Mann-Whitney test.
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