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Published on: November 5, 2019
Age at diagnosis of sickle cell disease in a developing country
B J Brown1, B F Akinkunmi, O J Fatunde
1Department of Paediatrics, University College Hospital, Ibadan, Nigeria. biosbrown@yahoo.com
Insights
This study found that children diagnosed with sickle cell disease (SCD) at University College Hospital Ibadan were diagnosed later than ideal. Earlier diagnosis was linked to Hb SS, higher socioeconomic status, and dactylitis history.
Area of Science:
- Pediatrics
- Hematology
- Public Health
Background:
- Sickle cell disease (SCD) is a significant inherited blood disorder.
- Early diagnosis of SCD is crucial for timely intervention and improved outcomes.
- Understanding factors influencing age at diagnosis can inform public health strategies.
Purpose of the Study:
- To determine the median age at diagnosis for sickle cell disease in children.
- To identify factors influencing the age at diagnosis at University College Hospital Ibadan.
Main Methods:
- A retrospective study was conducted reviewing case notes of 457 children with SCD.
- Data collected included hemoglobin phenotype, socioeconomic class, and history of dactylitis.
- Statistical analysis was performed to identify significant factors.
Main Results:
- The median age at diagnosis was 2.0 years (range: 2.5 months - 14.0 years).
- Children with Hb SS were diagnosed earlier than those with Hb SC (p=0.01).
- Higher socioeconomic class (p=0.003) and a history of dactylitis (p=0.000) were associated with earlier diagnosis.
Conclusions:
- Late diagnosis of sickle cell disease remains a challenge in Ibadan.
- Neonatal screening programs are recommended to facilitate early detection and improve survival rates.
Abstract:
In order to determine the age at diagnosis of sickle cell disease and some of the factors that influence the same at the University College Hospital Ibadan, a retrospective study of children with sickle cell disease who attended the children's outpatient department of the hospital between June 2000 and June 2009 was conducted by reviewing their case notes. A total of 457 children were studied (Male: Female ratio 1.1:1). Haemoglobin phenotype was SS in 421 children (92.1%) and SC in 36 children (7.9 %). Median age at diagnosis was 2.0 years (2.5 months - 14.0 years). Age at diagnosis was lower in children with Hb SS than HbSC (p = 0.01), in children from higher socioeconomic classes (p = 0.003) and in children with a history of dactylitis (N = 354, p = 0.000). Late diagnosis of haemogobinopathies in Ibadan calls for institution of neonatal screening to improve chances of survival.
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