Evaluation of Nutritional Status in Thalassemia Major Patients in Assiut Children Hospital

• ClinicalTrials.gov Identifier: NCT03161899
• Recruitment Status: Completed
• First Posted: May 22, 2017
• Last Update Posted: July 30, 2020
• Sponsor: Assiut University
• Information provided by (Responsible Party): ARAbdelmonem, Assiut University

Study Description

Brief Summary:

Thalassemia is a blood disorder passed down through families in which the body makes an abnormal form of hemoglobin. There are 2 main types of thalassemia; Alpha & Beta thalassemia. Alpha thalassemia: occurs when a gene or genes related to the alpha globin protein are missing or mutated.

Beta-thalassemia syndromes are a group of hereditary blood disorders characterized by reduced or absent beta globin chain synthesis. Beta-thalassemias can be classified into:

Silent carrier: completely asymptomatic with normal hematological parameters. Beta-thalassaemia minor (beta-thalassaemia trait): usually asymptomatic; diagnosis is made during a work-up for mild anemia.

Beta-thalassaemia intermedia: usually a similar presentation to beta-thalassaemia major; symptoms are usually less pronounced and the course is usually more insidious.

Beta-thalassaemia major : In which there is complete absence of hemoglobin A

Condition or disease
Thalassemia Major

Detailed Description:

In Egypt beta thalassemia-major is the most common type with carrier rate of 5.3 to ≥9%and 1000 new cases born with beta-thalassemia major per 1.5 million live births per year.

Children born with thalassemia major are normal at birth, but develop severe hemolytic anemia during the first year of life. Symptoms are those of anemia (lethargy, poor feeding, pallor…etc.) failure to thrive and organomegaly. Later on they develop signs of extra medullary hematopoiesis .

Optimal nutritional status is important for growth, immune function, bone health and pubertal development . Various reports suggest the incidence of poor growth ranges from 25% to 75% depending on thalassemia syndrome and severity of disease. This marked growth deficits raise a red flag for any pediatrician to evaluate nutritional status of thalassemic patients and detect possible nutritional deficiencies and associated factors.

Etiology of delayed growth and malnutrition reported in thalassemic patient is multifactorial including :

1. Nutritional deprivation with or without feeding difficulties arising from fatigue and breathlessness
2. Increased energy expenditure secondary to hyper metabolism with or without heart failure
3. Gastrointestinal hypoxia which consequently produces anorexia and malabsorption
4. Reduction of biosynthetic activity of liver.
5. Disturbance of the endocrine function
6. Impaired synthetic hepatic function secondary to hemosiderosis and hepatitis.

The main aim of this study is to assess the nutritional status of thalassemic patient attending Assiut university Children hospital and to determine the factors involved.

Study Design

• Study Type: Observational
• Actual Enrollment: 246 participants
• Observational Model: Case-Only
• Time Perspective: Cross-Sectional
• Official Title: Evaluation of Nutritional Status in Patients With Thalassemia Major in Assiut University Children Hospital
• Actual Study Start Date: December 15, 2018
• Actual Primary Completion Date: May 24, 2020
• Actual Study Completion Date: July 20, 2020

Groups and Cohorts

Outcome Measures

Primary Outcome Measures :

1. percentage of malnutrition [ Time Frame: 12 month ]
   prevalence of malnutrition among thalassemic children attending assiut university children hospital

Secondary Outcome Measures :

1. aetiology poor growth [ Time Frame: 12 month ]
   determination of the most common causes responsible for poor growth seen in thalassemic patients
2. decrease morbidity [ Time Frame: 18 month ]
   decrease morbidity by providing possible strategies for early prevention of the problem of poor growth occurring in patients with thalassemia major

Eligibility Criteria

• Ages Eligible for Study: 6 Years to 14 Years (Child)
• Sexes Eligible for Study: All
• Accepts Healthy Volunteers: No
• Sampling Method: Non-Probability Sample

Study Population

all beta thalassemic patients attending the children Hematology Clinic, Children Hospital, Assiut University, during the period of 1st of June 2017 till 31 th of may 2018.

Criteria

Inclusion Criteria:

• patients diagnosed to have thalassemia

Exclusion Criteria:

• patient with any underlaying systemic diseases other than B thalassemia major.

Contacts and Locations

Locations

Egypt

Asmaa Refaat Abdelmonem

Assiut, Egypt

Sponsors and Collaborators

Assiut University

Investigators

• Principal Investigator: asmaa refaat, MBBCH; Assuit , faculty of medicine, egypt

More Information

Publications:

Soliman AT, El-Matary W, Fattah MM, Nasr IS, El Alaily RK, Thabet MA. The effect of high-calorie diet on nutritional parameters of children with beta-thalassaemia major. Clin Nutr. 2004 Oct;23(5):1153-8. doi: 10.1016/j.clnu.2004.03.001.

Fung EB. Nutritional deficiencies in patients with thalassemia. Ann N Y Acad Sci. 2010 Aug;1202:188-96. doi: 10.1111/j.1749-6632.2010.05578.x.

Galanello R, Origa R. Beta-thalassemia. Orphanet J Rare Dis. 2010 May 21;5:11. doi: 10.1186/1750-1172-5-11.

• Responsible Party: ARAbdelmonem, resident doctor of pediatrics, Assiut University
• ClinicalTrials.gov Identifier: NCT03161899
• Other Study ID Numbers: ENST
• First Posted: May 22, 2017
• Last Update Posted: July 30, 2020
• Last Verified: July 2020

Individual Participant Data (IPD) Sharing Statement:

• Plan to Share IPD: No

• Studies a U.S. FDA-regulated Drug Product: No
• Studies a U.S. FDA-regulated Device Product: No

Keywords provided by ARAbdelmonem, Assiut University:

thalassemia - nutrition -growth

Additional relevant MeSH terms:

Thalassemia; beta-Thalassemia; Anemia, Hemolytic, Congenital; Anemia, Hemolytic; Anemia; Hematologic Diseases; Hemoglobinopathies; Genetic Diseases, Inborn