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Sickle cell disease in central India.

Archana B Patel1, Ambarish M Athavale

  • 1Department of Pediatrics & Clinical Epidemiology Unit, Indira Gandhi Medical College, Nagpur, India. archana@giasbm01.vsnl.net.in

Indian Journal of Pediatrics
|September 28, 2004
PubMed
Summary

In India, malnutrition and non-compliance with penicillin prophylaxis significantly increase the risk of sickle cell disease (SCD) complications and infections in children. These factors heighten susceptibility to pain crises and other severe health issues.

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Area of Science:

  • Pediatrics
  • Hematology
  • Infectious Diseases

Background:

  • Sickle Cell Disease (SCD) management in India lacks comprehensive data on disease incidence and risk factors, particularly concerning vaccination and prophylaxis.
  • Understanding these factors is crucial for improving patient outcomes and developing targeted interventions.

Purpose of the Study:

  • To determine the incidence and risk factors for sickle cell crises (SCC) and infections in Indian children with SCD.
  • To evaluate the impact of pneumococcal vaccination and penicillin prophylaxis on disease outcomes.

Main Methods:

  • A prospective hospital-based study followed 325 children with SCD on penicillin prophylaxis for over 146 person-years.
  • 161 children received pneumococcal vaccination; data on crises, infections, and risk factors were collected.

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Main Results:

  • The incidence of SCC was 1.25 per patient-year, and infections occurred at 1.38 per person-year.
  • Key risk factors for both SCC and infections included protein energy malnutrition (PEM), Mahar caste, and non-compliance with medication.

Conclusions:

  • Malnutrition and non-compliance with medication are significant risk factors that increase susceptibility to SCC and infections in children with SCD.
  • These findings highlight the need for improved nutritional support and adherence monitoring in SCD management in India.