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Prevalence of malnutrition, its associated factors and barriers to attaining adequate nutrition among children with sickle cell disease in Eastern Uganda: mixed study design

Year: 2026

Type: article

Abstract: BACKGROUND: Malnutrition is a major public health problem among children with sickle cell disease (SCD). In sub-Saharan Africa, the prevalence of malnutrition among children with SCD ranges from 35% to 40%. OBJECTIVE: This study determined the prevalence of malnutrition, its associated factors, and barriers to attaining adequate nutrition among children under 18 years with sickle cell disease. METHODS: A convergent parallel mixed design was used. Quantitative component included 365 children under 18 years with sickle cell disease, systematically sampled. Qualitative component involved in-depth interviews with 10 caregivers age ≥ 18 years and 6 key informant interviews with healthcare workers. The associated factors were analyzed using a modified Poisson regression model. Qualitative data were analyzed using inductive thematic analysis. RESULTS: The prevalence of malnutrition among 365 children with sickle cell disease was 20% (95% CI: 15.9%-24.1%). Factors associated with malnutrition included having a male primary caregiver (aPR = 1.441, p = 0.035, 95% CI: 1.026-2.024), low monthly family income (aPR = 1.700, p = 0.011, 95% CI: 1.127-2.565), lack of support systems (aPR = 2.247, p < 0.001, 95% CI: 1.461-3.454), eating fewer than three meals per day (aPR = 1.798, p = 0.002, 95% CI: 1.236-2.616), lack of dietary diversity (aPR = 6.800, p = 0.002), lack of available medication at the facility (aPR = 1.503, p = 0.048, 95% CI: 1.003-2.251), and no penicillin prophylaxis (aPR = 0.626, p = 0.044). CONCLUSION: Malnutrition affects a substantial proportion of children with sickle cell disease. It is strongly associated with poor socioeconomic conditions and inadequate feeding practices. Strengthening family-centered nutrition interventions, improving caregiver support, and enhancing access to essential health services are recommended.

Source: BMC Pediatrics

DOI: 10.1186/s12887-026-07513-y