An observational study of children with sickle cell disease in Kilifi, Kenya

Area of Science:

• Hematology
• Pediatrics
• Global Health

Background:

• Sickle cell disease (SCD) disproportionately affects sub-Saharan Africa, yet clinical data from children in this region are scarce.
• Understanding SCD's presentation in East Africa is crucial for improving patient outcomes.
• Previous research has not fully detailed the pediatric SCD experience in rural African settings.

Purpose of the Study:

• To describe the clinical characteristics of children with sickle cell disease in Kilifi, Kenya.
• To compare the clinical features of SCD in East African children with those in developed countries.
• To identify key health indicators and complications in pediatric SCD patients in a rural African setting.

Main Methods:

• Prospective observational study involving 124 children with SCD attending a specialist clinic in Kilifi, Kenya.
• Data collection included physical examinations (splenomegaly, hepatomegaly), malaria testing, hemoglobin levels, and liver function tests.
• Comparison with non-SCD controls and analysis of clinical manifestations across age groups.

Main Results:

• The study included 124 children with a median age of 6.3 years; 33% had splenomegaly and 20% had hepatomegaly.
• Mean hemoglobin was 73 g/l (vs. 107 g/l in controls), with elevated plasma bilirubin and aspartate aminotransferase.
• Hospital admission occurred in 39% of children, with two deaths; malaria prevalence was 6% during clinic visits.

Conclusions:

• Pediatric SCD patients in Kilifi exhibit anemia and liver dysfunction comparable to those in developed countries.
• Splenomegaly is a persistent clinical feature in children with SCD in this East African population.
• The study provides essential clinical data on SCD in rural East Africa, highlighting specific regional characteristics.