Original Research Article
Year: 2018 | Month: July | Volume: 8 | Issue: 7 | Pages: 18-27
The Pattern of Morbidity in Adult Nigerians with Sickle Cell Anaemia: A Tertiary Healthcare Setting Perspective
Akpan, I S1; Uboh, E E2
1Department of Haematology, University of Uyo, Uyo, Nigeria
2Department of Haematology, University of Uyo Teaching Hospital, Uyo, Nigeria
Corresponding Author: Akpan, I S
Background: Sickle Cell Anaemia (SCA) is the commonest genetic disorder affecting the black race globally. Nigeria has the highest SCA burden of any country. Patients with SCA often require frequent hospital care and sometimes die from its complications owing to the peculiar pathologic nature of the disease. Data on the causes of morbidity in adults with SCA in our centre are lacking. Measures geared toward improving the patients’ survival and quality of life can only be be useful if information about the causes of illnesses and deaths from SCA are elucidated. This would engender effective preventive strategies and appropriately targeted interventions.
Aim: To determine the pattern of illnesses among adults with Sickle Cell Anaemia, managed at the University of Uyo Teaching Hospital, Uyo.
Methods: All casenotes of adult patients with confirmed SCA managed in the Haematology Department over a two year period, from January 1, 2016 to December 31, 2017, were retrospectively reviewed for pattern of morbidity of SCA.
Results: A total of 64 patients were admitted over the study period for various complications of SCA. The age range was 20-70 years with a median age of 24.9years. Twenty-five (39.1%) were males and thirty-nine (60.9%) were females. There were four deaths during the period. The different morbidities encountered were vaso-occlusive crises (93.8%), Malaria (84.4%), Chronic leg ulcer (15.6%), hyperhaemolytic crises (10.9%), avascular necrosis of the femoral head (10.9%), pentazocine addiction (9.4%), acute chest syndrome (7.8%), septicaemia (7.8%), priapism (7.8%), chronic osteomyelitis (4.7%), nephropathy (4.7%), peptic ulcer disease (4.7%), deep vein thrombosis (4.7%), seizure disorder (4.7%), short stature with kyphoscoliosis (4.7%), stroke (3.1%), hepatopathy (3.1%), urinary tract infection (1.6%), lobar pneumonia (1.6%), pulmonary embolism (1.6%) and congestive cardiac failure (1.6%).
Conclusion: SCA is associated with multiple end-organ dysfunctions and variable clinical outcome. Admissions in our centre were mainly due to vaso-occlusive crises and malaria. Chronic renal failure was the leading cause of death followed by hyperhaemolytic crisis and pulmonary embolism. Early recognition and management of the morbidities seen in SCA are key to the survival of patients with the disease.
Key words: Sickle cell anaemia, vaso-occlusive crises, hyperhaemolytic crises, pentazocine addiction, Uyo.