Comparative study of nutritional status of children and adolescents with sickle cell anemia in Enugu, Southeast Nigeria.

BACKGROUND: Poor growth and nutritional status are common features of sickle cell anemia (SCA) in children. The rising trend of obesity in children in developing countries has been reported despite a huge burden of undernutrition in these settings. In SCA, overweight/obesity is being increasingly reported. AIMS: To evaluate the nutritional status and its determinants in children with SCA and to compare the same with hemoglobin AA (HbAA) controls of similar age, gender, and socioeconomic status. METHODS: The study was a cross-sectional analytical study involving 175 subjects and controls aged 1-18 years who met the inclusion criteria. Weight and height were measured and body mass index (BMI) was calculated. Z scores were computed for the anthropometric measurements using the World Health Organization (WHO) standard reference. Hemoglobin concentration was determined using HemoCue Hb201+ Analyzer. RESULTS: Subjects had significantly lower Z- scores for weight, height, and BMI compared with controls. Stunting, wasting, and overweight/obesity were observed in 10.9%, 24.6%, and 5.1% of subjects compared with 2.3%, 5.7%, and 9.7% respectively in controls. Wasting, stunting and overweight/obesity in SCA were significantly associated with age while overweight/obesity was significantly associated with upper social class (P = 0.001). CONCLUSIONS: Poor growth and nutritional status are still prevalent while overweight and obesity are emerging comorbidities among children with SCA in our environment. Regular nutritional assessment of children with SCA should be encouraged while those at risk of under/over-nutrition should receive adequate nutritional rehabilitation to prevent possible complications.

Prevalence and Pattern of Psychosocial Disorders among Caregivers of HIV-infected Children in Enugu, South-Eastern Nigeria.

BACKGROUND: Nigeria has the highest burden of paediatric HIV in the world. HIV infection may result in significant life stressors, on both the infected children and their caregivers. METHODS: This included a hospital-based cross-sectional and comparative study. Subjects and controls who met the inclusion criteria were enrolled consecutively. Their socio-demographic variables were obtained and GHQ-28 was used to assess their psychosocial status. RESULTS: A total of 154 caregivers of HIV-infected children (subjects) and 154 caregivers of HIV-negative children (controls) were enrolled into this study. In total, 42 (27.3%) and 112 (72.7%) of the subjects were males and females, respectively, compared with 37 (24.0%) and 117 (76.0%) of the controls, respectively. The prevalence of psychosocial disorders among the subjects and controls was 39 and 2.6%, respectively (p < 0.001; odds ratio: 23.936). The patterns of psychosocial disorders among the caregivers of HIV-infected children were somatic symptoms (85%), anxiety/insomnia (80%), social dysfunction (63.3%) and severe depression (48.3%). CONCLUSION: There is a high prevalence of psychosocial disorders among caregivers of HIV-infected children.

Relationship between zinc levels and anthropometric indices among school-aged female children with sickle cell anemia in enugu, Nigeria.

BACKGROUND: Sickle cell anaemia is one of the most common inherited disorders globally. Some affected children have retardation of physical growth which is also seen in those with zinc deficiency. OBJECTIVE: To assess the relationship between zinc levels and anthropometric indices of SCA children. METHODS: A cross- sectional, case-control study on young females aged 6-18 years at the UNTH, Enugu. Relevant clinical data as well as 24 hour dietary recall were collected. Weights and heights were measured using standard protocols and BMI calculated. Serum zinc was determined using Atomic Absorption Spectrophotometer. Data was analyzed using SPSS version 15.0 while the level of statistical significance was set at P < 0.05. RESULTS: Eighty-one subjects with HbSS and 81 matched controls with HbAA were studied. Mean weights of 34.58 ± 12.76kg found in patients were significantly lower than 40.19 ± 13.37kg in controls. Also mean BMI of 16.27 ± 2.76kg/m2 in patients were significantly lower than 18.40 ± 2.96kg/m2 in controls (P = 0.01). Mean heights of patients were lower than that of the controls though not significantly so (P > 0.05). Mean serum zinc levels of 58.01 ± 10.58µg/d1 in patients were significantly lower than 68.37 ± 8.6µg/dl in controls (P = 0.01). Positive correlation was found between serum zinc and BMI of the studied children. Serum zinc has a significant relationship with weight, height and BMI. CONCLUSION: Reduced serum zinc in SCA children was associated with low anthropometric indices. Estimation of serum zinc is also recommended in SCA children with low anthropometric indices.

Serum selenium status of HIV-infected children on care and treatment in Enugu, Nigeria

Objective. To compare the selenium status of HIV-infected and HIV-uninfected children. Methods. This was a hospital-based comparative study using a structured questionnaire in the quantitative research domain at the University of Nigeria Teaching Hospital, Ituku/Ozalla, Enugu, Nigeria. Seventy-four HIV-infected children were compared with 74 non-HIV-infected children (35 males and 39 females in each group). The outcome measure was the selenium status of the study participants. Results. The mean (standard deviation (SD)) weight-for-height z-score among the subjects was ­0.18 (1.53) compared with 0.05 (1.68) among the controls (p=0.457). The mean (SD) height-for-age z-score among the subjects was ­1.16 (1.44) compared with 0.06 (1.06) among the controls (p<0.001). Eighteen subjects (24.3%) compared with eight controls (11.4%) were selenium deficient (odds ratio 2.49; 95% confidence interval 1.00 - 6.18; p=0.044). Median CD4 counts of selenium-deficient and non-deficient subjects were 765.5 (range 409 - 1 489) and 694.0 (range 85 - 2 196) cells/µL, respectively (p=0.321). The proportions of selenium deficiency were 26.4% and 22.2% in the highly active antiretroviral therapy (HAART) and pre-HAART groups, respectively (p=0.565). Conclusion. There was a significant difference in the proportion of HIV-infected children who were selenium deficient compared with their uninfected counterparts

HIV status disclosure rate and reasons for non-disclosure among infected children and adolescents in Enugu, southeast Nigeria.

AIMS: To determine the rate of HIV status disclosure, caregivers' reasons for non-disclosure, and factors influencing disclosure among a sample of HIV-infected children in Enugu, southeast Nigeria. METHODS: Data were collected prospectively via a questionnaire on HIV-infected children and their caregivers who visited the pediatric HIV clinic of the University of Nigeria Teaching Hospital between July 1, 2012, and June 30, 2013. The data analysis was performed using Statistical Package for the Social Sciences version 19 software. RESULTS: Caregivers of 107 children (age 5-16 years; mean 10.1 ± 3.2 years) were enrolled in the study. There were 53 (49.5%) boys and 54 (50.5%) girls. HIV status had been disclosed to 31 (29%) of them. The major reason for non-disclosure was the child being considered too young. Age (p < .001), age at HIV diagnosis (p < .001) and baseline CD4 count (p = .008) were seen as significant predictors of HIV disclosure. CONCLUSIONS: There is a low rate of HIV disclosure to infected children, and it was found to be lower for younger children. We recommend improving efforts for disclosure counseling to caregivers in pediatric HIV clinics.

Knowledge and awareness of personal sickle cell genotype among parents of children with sickle cell disease in southeast Nigeria.

Sickle cell trait (SCT; HbAS), the heterozygous state for the sickle cell allele of the beta globin gene, is carried by as many as 100 million individuals worldwide. Nigeria has the highest prevalence of SCT, impacting an estimated 25 % of adult population. This study was designed to assess timing of awareness, knowledge of SCT status and preferred method of education among parents of children with sickle cell disease (SCD). We conducted a cross-sectional survey of parents of children with SCD from June 2013-March 2014. Participants completed a 20-item questionnaire to assess (1) awareness of personal sickle cell genotype, (2) timing of awareness of personal sickle cell genotype, and (3) knowledge of SCT. One hundred and fifty-five participants completed the survey. Seventy-eight percent were females, and 87 % (135/155) were aware of their own sickle cell genotype. Timing of awareness varied as follows: following birth of a child with sickle cell disease (45 %); during marriage (21.5 %); school admission (9.6 %); during pregnancy (9.6 %); and other times (14 %). Approximately 35.5 % of participants thought that sickle cell trait was a mild form of sickle cell disease. Radio (43.9 %), informational community meetings (27.7 %), and television (21.9 %) were identified by participants as the most effective method of increasing sickle cell trait awareness. Innovative approaches are needed to increase the proportion of individuals who are aware of their own sickle cell genotype prior to having a child with sickle cell anemia in line with the Healthy People 2020 objective.

Progressive myelopathy, a consequence of intra-thecal chemotherapy: case report and review of the literature.

Intra-thecal chemotherapy is a recognized therapy for hematological malignancies such as acute lymphoblastic leukemia (ALL). Despite the advantage of these drugs in treating or preventing central nervous system disease, they are not without complications. The authors describe a 12-year-old girl with ALL, who developed progressive myelopathy following intra-thecal administration of cytosine arabinoside. Initial presentation was urine and fecal retention that progressed to paraplegia, and finally encephalopathy. magnetic resonance imaging of the neuroaxis showed T2-weighted foci of increased signal intensity within the substance of the cervical cord indicative of myelopathy. Physicians should be wary of this rare complication of intra-thecal chemotherapy.

Diagnostic delay in pediatric cancer in Enugu, Nigeria: a prospective study.

Childhood cancer is a leading cause of childhood mortality in developed countries though ranks lower than infections in developing countries. Most patients with malignancies present late to hospital with consequent adverse outcome. Early diagnosis, therefore, is an important requirement in pediatric oncology as delayed diagnosis is associated with poor prognosis and huge economic cost. The study aims to identify factors associated with delay in the diagnosis of childhood cancer at University of Nigeria Teaching Hospital, Enugu.Children aged 0-17 years with admitting diagnosis of cancer which was histologically confirmed were reviewed prospectively over a 3-year period. An interviewer structured questionnaire was administered to patients or parents/caregivers to obtain information on patients' biodata, their symptoms as well as visit to health professionals or alternative health care providers before presentation at this hospital.Ninety patients were confirmed to have cancer. Overall median lag time (LT) was 15.7 weeks. Major contributors to delay were parents and the type of cancer patients presented with. Acute lymphoblastic leukemia (ALL) had the shortest median LT of 4.2 weeks while Hodgkin's disease had the longest median LT of 53.6 weeks (p = 0.01, Mann-Whitney test, 2-tailed). The median parent's delay was 12.3 weeks and health system delay was 3.6 weeks showing a significant difference in the two categories of delay (p < 0.0001, Mann-Whitney test, 2-tailed). The median treatment delay was 5 days.Public awareness and health system reform is imperative in reducing the delay in diagnosis of childhood cancer in our environment.

Prevalence and Risk Factors of Anaemia in Paediatric Patients in South-East Nigeria

Background. The causes of anaemia have regional variations; and further variation is expected among paediatric hospital patients. However; the prevalence of anaemia and its contributing risk factors among paediatric patients remain understudied in South-East Nigeria.Methods. The study involved 286 anaemic (haemoglobin (Hb) ?10 g/dL) and 295 non-anaemic preschool children attending a hospital outpatient department. A clinical research form was used to document demographic data; anthropometric measurements; disease details and packed cell volume. Common anaemia risk factors previously documented were studied. The prevalence rates of the independent variables were calculated and level of significance was determined; using ?2.Results. The prevalence of anaemia was 49.2; with the highest prevalence among children 12 months old (p

Current sickle cell disease management practices in Nigeria.

BACKGROUND: Although Nigeria has the highest burden of sickle cell disease (SCD) worldwide, there is still variable and poor utilisation of standard-of-care practices for SCD patients in the country. METHODS: This was a questionnaire survey of doctors in some dedicated SCD clinics in Nigeria in order to document the facilities available and common management practices. RESULTS: There were responses from 18 clinics based in 11 institutions. The number of patients being followed in each centre ranged from 15 to approximately 11 000. All clinics provided malaria prophylaxis and folic acid routinely to their patients. Only eight clinics prescribe penicillin prophylaxis. Eight prescribe hydroxyurea to patients who can afford it when indicated. All of the centres except three have electronic cell counters, but all had access to haemoglobin electrophoresis. Three had high-performance liquid chromatography machines installed but none was being routinely used. One institution had a functioning molecular biology laboratory. There is no official newborn screening programme in the country. All had access to microbiology and chemistry laboratories. Nine institutions had CT, six had MRI and three had transcranial Doppler facilities. CONCLUSION: The care available for SCD in Nigeria is still suboptimal and there is an urgent need for concerted effort to tackle the problem, but to make a significant impact on the burden of the disease would require more focus at the primary care level. Some steps to achieving this are outlined.

Coagulation profile of children with sickle cell anemia in steady state and crisis attending the university of Nigeria teaching hospital, Ituku-Ozalla, Enugu.

BACKGROUND: Sickle cell anemia is associated with a hypercoagulable state that may lead to alterations in a coagulation profile. Measurements of coagulation factors are known to have some predictive value for clinical outcome. OBJECTIVES: To determine the coagulation profile of children with SCA in steady state and crisis and compare it with those with normal HbAA genotype. MATERIALS AND METHODS: This is a prospective observational study involving 50 children with SCA in steady state, 50 in crises, and 50 with HbAA genotype, carried out from June to October 2009. All the values of coagulation profile were matched for age and sex. RESULTS: The mean Prothrombin time (PT) (12.5 ± 1.2 secs), Activated partial thromboplastin time (aPTT) (41.6 ± 1.0 secs), and Thrombin time (TT) (12.3 ± 1.2 secs) of subjects with SCA in steady state as well as those during crises [PT (12.6 ± 1.8 secs), aPTT (45.6 ± 1.3 secs), TT (12.5 ± 1.7 secs)] were significantly prolonged compared to those of subjects with HbAA genotype. The mean bleeding time (BT) of 3.4 ± 1.0 mins was significantly shorter in children with SCA in steady state compared to those with HbAA genotype (3.7 ± 1.1 mins), (P < 0.038). CONCLUSION: Coagulation profile of patients with SCA is prolonged both in steady state and during crisis and when compared to those with HbAA genotype, though all values are within normal range.

Prevalence of hypoxemia among children with sickle cell anemia during steady state and crises: a cross-sectional study.

BACKGROUND: Patients with sickle cell anemia (SCA) are prone to recurrent pain crises related to red blood cell sickling and vaso-occlusion with subsequent tissue hypoxia. Alveolar hypoxia has been shown to be associated with entrapment of sickle cells in the pulmonary microcirculation which may propagate a cycle of further hypoxemia and sickling. Pulmonary complications are common in sickle cell disease (SCD) and may exacerbate microvascular occlusive phenomena. Thus, detecting hypoxemia is of particular importance in SCD. OBJECTIVES: This study was designed to determine the prevalence of hypoxemia among children with SCA and compare the oxygen saturation of those in crises with those in steady state. MATERIALS AND METHODS: This is a prospective observational study involving 46 children with SCA in steady state, 42 with crises, and 42 with HbAA genotype carried out between August and December 2010. The study compared the oxygen saturation of sickle cell anaemic children in steady state and in crises with normal hemoglobin genotype using Nellcon pulse oximeter while the hemoglobin concentration was analyzed using automated Sysmex KX-21N model. RESULTS: A total of 130 participants aged 6 months to 18 years were recruited. The overall prevalence of hypoxemia in this study was 13.8%. Hypoxemia was highest among SCA patients in the crisis state (23.8%) compared to 13% and 0% for those in the steady state and in those with normal hemoglobin genotype, respectively (χ² = 6.425, P = 0.04). Hypoxemia was higher among those with hemoglobin less than 5 g/dl (30%) and least among those whose hemoglobin levels were 10 g/dl and above. CONCLUSIONS: Hypoxemia was significantly higher among children with SCA during Vaso-occlusion crises. We recommend that one should have a high index of suspicion and take prompt action in managing these individuals especially those with acute chest syndrome.

AUDIT OF BLOOD TRANSFUSION PRACTICES IN THE PAEDIATRIC MEDICAL WARD OF A TERTIARY HOSPITAL IN SOUTHEAST NIGERIA.

OBJECTIVES: To determine the indications, practices and outcomes of transfusion on children. DESIGN: A descriptive retrospective study. SETTING: Paediatric wards of University of Nigeria Teaching Hospital, Enugu, Nigeria. SUBJECTS: Children one month to 18 years that received blood transfusion. MAIN OUTCOME MEASURES: Indications for the transfusion, haemoglobin rise, vital signs, duration of transfusion and adverse events. RESULTS: The two hundred and thirty eight transfusions reviewed were given amongst 95 patients, at a ratio of 2.5 transfusions per patient. The indicators of the transfusion were: malignancy (31.7%), sepsis (15.1%), sickle cell anaemia (12.1%), malaria (10.0%), hyperbilirubinaemia (10.0%), HIV/AIDS (8.3%), nephrotic syndrome (7.2%) and malnutrition (5.4%). Whole blood (56.4%) and sedimented cells (36.3%) were the main types of blood transfused. About 96.4% were transfused appropriate volume of blood. The mean Haemoglobin concentration (Hb) increase was 3.1g/dl and 12.8% of the recipients recorded an Hb increase of 5g/dl. The mean duration of transfusion was 4.6 hours and 59.7% of the transfusions exceeded the recommended four hours. Pulse and respiratory rates returned to normal post transfusion in 26.1 and 21.8% of the recipients respectively. In 10% of the transfusions there were minor adverse events; chills/fever (5.1%), itching (3.4%), hypothermia (1.0%) and vomiting (0.5%). CONCLUSION: Blood transfusion in this tertiary institution is not common and mainly due to non-communicable diseases. The expected optimal rise in Hb and normalising of vitals sign are not always the case. The duration of most transfusions was unduly prolonged and transfusion-related adverse events are rare.

Prevalence of Human Immunodeficiency Virus Transmission among Transfused Children with Sickle Cell Anemia in Enugu Nigeria

Background: There are a number of routes for human immuno-deficiency virus (HIV) transmission in children. Blood transfusion-related HIV is still common in developing countries like Nigeria especially among high risk children such as those who require repeated blood transfusions. Aim: The aim of this study was to find the prevalence of HIV among transfused children with sickle cell anemia in Enugu. Subjects and Methods: This is a descriptive cross-sectional study conducted at the Sickle Cell Clinic of the University of Nigeria Teaching Hospital; Enugu Sixty-nine transfused children with SCA were enrolled after obtaining consent from their caregivers and assent from older children. Non transfused children matched for age; sex; and social status with the subjects served as control. Voluntary counseling and testing were then provided. Relevant data were obtained using pretested questionnaire. Statistical Package for Social Science (SPSS) version 11 (Chicago; IL) was used for data analysis. The chi-square was used to test for significant association of categorical variables and a P-value of less than 0.05 accepted as significant. Results: HIV antibodies were found in 2.9 (2/69) of the subjects and in 1.6 (1/64) of the control (P = 0.604). All the infected individuals among the subjects were males; had only been transfused once and were from the lower socioeconomic class. The only infected child from the control group was a 7-year-old male and he probably acquired it through vertical transmission since the mother also tested positive to HIV antibody. Conclusions: Blood transfusion is still a risk factor for HIV transmission among children with sickle cell anemia in Nigeria. Strategies that will ensure improved blood transfusion safety at health facilities need to be strengthened

Pre-hospital management of diarrhoea among caregivers presenting at a tertiary health institution: implications for practice and health education.

BACKGROUND: Diarrhoeal diseases cause significant childhood morbidity and mortality worldwide. The effectiveness of home management of diarrhoeal diseases is achievable only if caregivers have appropriate information despite varying recommendations on the strategies for diarrhoea therapy. OBJECTIVES: To evaluate caregivers' perception and use of ORT fluids for management of diarrhoea in under-five age children in the face of varying phases of recommendations, as an indicator of home treatment. METHODS: Caregivers of U5 children presenting with acute watery diarrhoea to different Paediatrics clinics/wards of the University of Nigeria Teaching Hospital (U.N.T.H.), Enugu between October 2006 and February 2007 were interviewed with a structured questionnaire. RESULT: Caregivers of 156 under-five children who met the inclusion criteria were recruited. Access to ORT fluids was high with 73.1% of all children with diarrhoea being offered an ORT fluid at home. However, the method of preparation and administration of fluids was quite unsatisfactory. Previous experience with ORT fluids, higher educational or socioeconomic status did not correlate significantly with better performance. CONCLUSION: Despite high level of knowledge and acceptance of ORT among the study population actual practice was not satisfactory. Diverse practices by caregivers which represent the various phases of evolution in the types of fluids promoted for oral rehydration reflect some confusion that require urgent attention. Knowledge and skills of ORT need to be widely promoted on a continuing basis with the need for health workers to ensure that caregivers are taught and adhere to the correct recommendations on oral rehydration therapy.

Assessment of Clinical Features and Haematocrit Levels in Detection of Hypoxaemia in Sick Children

This cross-sectional study was to determine the prevalence of hypoxaemia among sick children in EnuguState University Teaching Hospital, Enugu, Nigeria and correlate it with clinical features and haematocrit levels.Ninety-two (92) sick children aged 2­48 months hospitalised at the teaching hospital were recruited after obtaining consent from their carers.The prevalence of hypoxaemia in this study, defined by oxygen saturation of less than 90%, was 13%, and was not dependent on age or sex. A higher proportion of subjects with hypoxaemia had tachypnoea (81.8%),compared with those without (18.2%) (χ² = 1.69; p=0.19).The sensitivity of using tachypnoea alone to predict hypoxaemia was 18.4% while the specificity was 92.3%.The presence of hypoxaemia predicted poor outcome 66.7% of those that died had hypoxaemia. The difference was statistically significant (χ2= 17.9; p=0.00).Tachypnoea had a poor sensitivity although good specificity in predicting hypoxaemia. Presence of hypoxaemia connotes poor prognosis. We recommend that finger pulse oximeters, which are cost effective,should be routinely available at hospitals in developing countries, so that hypoxaemia can be detected earlier and more intensive management instituted

Impact of socioeconomic status on sexual maturation of Nigerian boys living with sickle cell anaemia.

BACKGROUND: Assessment of sexual maturation of children continues to have great relevance in monitoring their overall development. The interplay between innate disease characteristics and environmental modifiers such as socioeconomic status is not clearly understood among children with sickle cell anaemia (SCA). OBJECTIVE: To evaluate impact of socioeconomic status on sexual development of children living with sickle cell anaemia. METHODS: A cross-sectional case-control study evaluating sexual maturation of male patients with SCA (subjects) compared with non-SCAs (controls) was done. Tanner staging and testicular volume (TV) assessment were used for evaluating sexual maturation among both groups matched for age and socioeconomic status. Pattern of sexual maturation was related to socioeconomic status. RESULTS: Subjects demonstrated delay in onset and completion of sexual maturation compared to controls. Testicular volumes of subjects were smaller than controls but when related to Tanner staging showed no significant difference between both groups. Onset of puberty was earlier in children from higher socioeconomic classes though this was very modest and not statistically significant. Similarly children of higher classes showed slightly larger TVs compared with those from lower classes. CONCLUSION: SCA patients continue to demonstrate delay in sexual maturation compared with controls with normal haemoglobin genotype. Higher socioeconomic status showed a slight improvement on sexual maturation. This should provide a strong basis for advocacy to improve the welfare of families of children living with SCA as a worthwhile measure to improve their development and overall outlook. A larger study of a prospective nature is highly indicated.

Demographic and sociocultural characteristics of sickle anaemia children with positive hepatitis B surface antigenaemia in a tertiary health facility in Enugu.

BACKGROUND: Hepatitis B virus) infection is contracted through contact with body fluid of infected persons. Patients with sickle cell anaemia (SCA), a common haematological disorder in Nigeria, have tendencies to visit traditional healers who administer scarifications and ritual marks that may expose them to HBV infection. OBJECTIVE: To determine the demographic and socio-cultural characteristics of children with SCA infected with HBV at the University of Nigeria Teaching Hospital Enugu. SUBJECTS AND METHOD: Two hundred and twenty one children aged 6 months to 17 years with SCA were recruited consecutively from October 2004 to April 2005. They were screened for HBsAg using ELISA method. RESULTS: There was no statistically difference in hepatitis B surface antigenaemia among different age group (P = 0.907). Social class did not significantly influence the prevalence of HBsAg among subjects (p = 0.887). Socio-cultural practices like circumcision and scarification did not influence the prevalence of HBsAg, (p = 0.636) (p = 0.771) respectively. Significantly higher number of people from lowest socioeconomic class practice scarification (p = 0.0001). CONCLUSION: Demographic and sociocultural factors do not appear to influence the prevalence of HBsAg among children with SCA in Enugu, Nigeria.

Evaluation of Sexual Maturity among Adolescent Male Sickle Cell Anaemia Patients: the Usefulness of Testicular Volume Estimation

Use of Tanner stages i.e. Sexual Maturity Rating; (SMR); in evaluation of sexual maturity has gained widespread acceptance. Tanner staging assesses pubic hair growth and increase in genital sizes; the latter of which is best reflected by the increase in testicular size. Testicular volume increases is thought to be the most sensitive clinical indication of onset and progress of puberty. It has been argued that the initial stage of sexual development may be missed if testicular volume is not assessed. We explored usefulness of testicular volume estimation for assessing sexual maturity among adolescent male sickle cell anaemia (SCA) patients. Methods: We conducted a cross-sectional case-control study evaluating sexual maturation of male patients with sickle cell anaemia and those with HbAA genotype. Tanner staging and testicular volume assessment were both used as models for evaluating stages of sexual maturation among SCA patients and their normal counterparts matched for age and socioeconomic status. Results: SCA patients demonstrated delay in onset and completion of sexual maturation. Testicular volumes (TV) of subjects were smaller than those of controls but when related to stages of sexual maturity; there was no statistically significant difference between both groups. The correlation coefficients between various stages of sexual maturity and TV suggest strong associations. Conclusion: Testicular volume increase is shown as a reasonably good predictor of onset and progression of sexual maturity in both SCA subjects and their healthy controls