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.