Acute chest syndrome in sickle cell disease patients: experience from a resource constrained setting

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Date
2019-10-17
Authors
Akinsete, A. M.
Majiyagbe, O. O.
Joacquin, A.
Temiye, E. O.
Akinsulie, A. O.
Journal Title
Journal ISSN
Volume Title
Publisher
Wolters Kluwer Medknow
Abstract
Introduction Sickle cell anemia is the most common inheritable hemoglobin disorder in the world with very high prevalence, morbidity and mortality in sub-Saharan Africa. Acute chest syndrome (ACS) is one of the most common causes of mortality among individuals with the condition. The management of this condition involves watchful waiting which may be deleterious in resource constrained settings. The use of exchange blood transfusion (EBT) has been reported to be beneficial. The use of this great intervention is further hampered in most of the developing world. The aim of this study was to review the outcome of children managed with an algorithm adopted in 2015 at a University Teaching Hospital in a resource constrained setting. Methods This was a retrospective study from January 2015 to December 2017 at a University Teaching Hospital. Ethical approval was obtained from the Hospital's Health, Research and Ethics committee. Results A total of 324 children with sickle cell disease were admitted in the period under review with a male to female ratio of 1.5:1. Thirty three patients were suspected of having ACS, but only 12 were confirmed using the algorithm. The mean age at presentation was 8 years with over 85% of the patients having a triad of fever, cough and chest pain. All the patients had EBT within 48 hours of admission and mortality rate recorded was 16.7% Conclusion The use of the algorithm as well as the preemptive EBT improved the outcome of the children accessing care at our facility
Description
Staff publications
Keywords
Research Subject Categories::MEDICINE , Acute chest syndrome , Sickle cell disease , Exchange blood transfusion , Research Subject Categories::MEDICINE
Citation
Akinsete AM, Majiyagbe O, Joacquim A, Temiye E, Akinsulie A. Acute chest syndrome in sickle cell disease patients: experience from a resource constrained setting, Iraqi J Hematol 2019 ;8: 53-7