Nomogram-based prediction of growth retardation in pediatric deletional α-thalassemia: Evidence from the Mekong Delta, Vietnam

Nghia Quang Bui; Ngoc Bich Tran; Tram Van Ta; Linh My Duong; Ngoc-Nga Pham-Thi; Vinh The Nguyen; Ly Cong Tran

doi:10.23750/abm.v96i2.16872

Authors

Nghia Quang Bui Department of Pediatrics, Faculty of Medicine, Can Tho University of Medicine and Pharmacy, Can Tho City, Vietnam https://orcid.org/0009-0002-6506-784X
Ngoc Bich Tran Department of Pediatrics, Faculty of Medicine, Can Tho University of Medicine and Pharmacy, Can Tho City, Vietnam; Medical Education and Skills Training Center, Can Tho University of Medicine and Pharmacy, Can Tho City, Vietnam https://orcid.org/0009-0007-1129-3944
Tram Van Ta Tien Giang General Hospital, Tien Giang, Vietnam
Linh My Duong Department of Obstetrics and Gynecology, Faculty of Medicine, Can Tho University of Medicine and Pharmacy, Can Tho City, Vietnam
Ngoc-Nga Pham-Thi Department of Biology and Genetics, Faculty of Basic Sciences, Can Tho University of Medicine and Pharmacy, Can Tho City, Vietnam https://orcid.org/0000-0002-9321-132X
Vinh The Nguyen Department of Pediatrics, Faculty of Medicine, Can Tho University of Medicine and Pharmacy, Can Tho City, Vietnam https://orcid.org/0009-0008-5176-5202
Ly Cong Tran Department of Pediatrics, Faculty of Medicine, Can Tho University of Medicine and Pharmacy, Can Tho City, Vietnam https://orcid.org/0000-0003-0090-7289

Keywords:

alpha-thalassemia, child, growth disorders, risk factors, predictive model, nomograms, Vietnam, Mekong Delta, pediatrics

Abstract

Background and aim: Growth retardation is a common complication in children with deletional α-thalassemia. Limited epidemiological data exist on growth retardation in α-thalassemia patients from low-resource settings such as Vietnam. This study investigates the prevalence and associated factors of growth retardation in pediatric patients with α-thalassemia to inform targeted interventions.

Methods: A multicenter cross-sectional study was conducted involving children with confirmed deletional α-thalassemia from August 2022 to June 2023. Clinical, laboratory, and genetic data were analyzed to identify predictors of growth retardation.

Results: Growth retardation affected 17.1% of the study population. Key predictors included splenomegaly ≥ grade II (OR = 12.5; 95% CI, 1.69–92.25; p = 0.013), hemoglobin levels <7 g/dL (OR = 7.67; 95% CI, 1.12–52.32; p = 0.038), and having siblings with thalassemia (OR = 13.5; 95% CI, 1.57–115.9; p = 0.018). A predictive nomogram was developed, demonstrating excellent discrimination with an area under the curve of 0.92 (95% CI, 0.82–1.0; p = 0.001) and good calibration (Hosmer–Lemeshow test, χ²(df) = 0.139 (1); p = 0.709).

Conclusions: This study highlights the prevalence and associated factors of growth retardation in pediatric patients with α-thalassemia in the Mekong Delta, Vietnam. By identifying key predictors and developing a practical predictive tool for early risk assessment, these findings provide a foundation for targeted interventions aimed at improving clinical outcomes, particularly in resource-limited settings.

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