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. 2020 Jan 2;9(1):119. doi: 10.3390/jcm9010119

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© 2020 by the authors.

Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).

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Proportion of children with sickle cell anemia (SCA) with malnutrition according to World Health Organization (WHO) and SCA-specific growth references. (a) Proportion of children with SCA defined as wasting, overweight, or obesity based on two reference populations. Using the WHO growth reference in children (5–12 years of age) with sickle cell anemia (SCA) living in northern Nigeria misclassified the prevalence of wasting when compared to the SCA-specific growth reference. McNemar’s test. A p-Value <0.05 was set for statistical significance. (b) Proportion of children with sickle cell anemia defined as having malnutrition. Using the WHO growth reference in children (5–12 years of age) with sickle cell anemia (SCA) living in northern Nigeria misclassified the prevalence of moderate malnutrition (body mass index (BMI) Z-score <−2 and >−3) and severe malnutrition (BMI Z-score <−3) in children with SCA living in Kano, Nigeria, categorized by WHO and SCA-specific growth reference. McNemar’s test. A p-Value < 0.05 was set for statistical significance.