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Associated morbidities in children with sickle-cell anaemia presenting with severe anaemia in a malarious area

J P Ambe1, J O Fatunde, O O Sodeinde

  • 1Department of Paediatrics, College of Medical Sciences, University of Maiduguri, Borno State, Nigeria.

Tropical Doctor
|February 24, 2001
PubMed

Insights

Sickle-cell anaemia (SCA) patients in crisis often face malaria and bacterial infections, increasing risks. Prompt evaluation and treatment of these infections are crucial for better outcomes in SCA patients.

Area of Science:

  • Hematology
  • Pediatrics
  • Infectious Diseases

Background:

  • Sickle-cell anaemia (SCA) is a severe genetic blood disorder.
  • Patients with SCA frequently experience painful crises, often associated with severe anaemia.

Purpose of the Study:

  • To investigate the common complications and outcomes of severe anaemia crises in SCA patients.
  • To identify factors associated with increased morbidity and mortality in SCA crises.

Main Methods:

  • Prospective study of 104 SCA patients with severe anaemia (PCV ≤ 15%).
  • Classification of crises based on physical findings, bilirubin, and reticulocyte counts.
  • Investigations included malaria testing, blood cultures, and radiological studies.

Main Results:

  • Malaria (66%) and bacterial infections (17.3%) were the most frequent complications.
  • Acute chest syndrome was more common in hyperhaemolytic and splenic sequestration crises.
  • Conjugated hyperbilirubinaemia was significantly higher in hyperhaemolytic crises (P=0.001).
  • Overall case fatality was 86.5/1,000 SCAs; no fatalities in aplastic crisis.

Conclusions:

  • Co-existing bacterial infections and conjugated hyperbilirubinaemia increase morbidity and mortality in SCA crises.
  • Early evaluation and prompt treatment of infections are vital for SCA patients in crisis.

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