NUTRITIONAL STATUS AND ASSOCIATED FACTORS IN TRANSFUSION-DEPENDENT BETA-THALASSEMIA MAJOR PEDIATRIC PATIENTS VISITING KANTI CHILDREN’S HOSPITAL

Abstract

The objective of the study was to assess the nutritional status and associated factors among transfusion-dependent pediatric patients with β-thalassemia major (β-TM) visiting Kanti Children's Hospital in Nepal. A cross-sectional, hospital-based, descriptive study was conducted on 92 β-TM patients aged 1 to 14 years receiving regular blood transfusions. Data were collected using structured questionnaires, anthropometric assessments, biochemical evaluations, and dietary assessments. Anthropometric data were analyzed using WHO Anthro and WHO AnthroPlus software, dietary data using food composition tables and dietary intake references, and statistical analyses were performed to analyze the associated factors with the nutritional status. Results showed that 27.2% of patients were stunted (moderate: 19.6%, severe: 7.6%) and 8.7% were underweight (moderate: 6.5%, severe: 2.2%), with stunting prevalence increasing significantly with age (p<0.05). Dietary analysis revealed inadequate caloric intake compared to age- and sex-specific requirements, suboptimal dietary diversity scores (mean: 4.230 ± 1.070), while protein intake exceeded estimated needs. Furthermore, body fat percentage showed significant sex-based differences and associations with age, chelation therapy (p<0.001), and total age of chelation (p<0.05). High serum ferritin levels (>2500 ng/ml) indicated a high prevalence of iron overload, persisting despite regular chelation therapy. Moreover, significant associations (p<0.05) were identified between nutritional status and various factors, including socioeconomic conditions, thalassemia-related aspects, and dietary practices. The study findings revealed compromised nutritional status in pediatric β-TM patients, influenced by disease-related factors, dietary inadequacies, and socioeconomic characteristics. The study underscores the need for comprehensive nutritional assessment and management as an integral part of β-TM care in this setting.