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Factors Associated with Splenomegaly amongst Patients with Sickle Cell Disease in Cameroon

Open Journal of Pediatrics 2022年第1期12卷 33-46页

作者： Eposse Ekoube Charlotte Alima Yanda Anastasia Nicole Djike Puepi Yolande Cheping Kouokam Line Mandeng Ma Linwa Edgar Françoise Ngnedjou Nwabufor Foute Mbono Ritha Epee Patricia wete estelle Hassanatou Iyawa Koki Ndombo Paul Olivier Sickle Cell Care Center Laquintinie Hospital Douala Cameroon Faculty of Medicine and Pharmaceutical Sciences University of Douala Douala Cameroon Higher Institute of Medical Technology Yaoundé Cameroon Chantal BIYA Foundation Mother Child Center Yaoundé Cameroon Faculty of Health Sciences University of Buea Buea Cameroon Cosendai Adventist University Nanga Eboko Cameroon Faculty of Medicine and Biomedical Sciences University of Yaoundé 1 Yaoundé Cameroon

Introduction: Sickle cell disease is the most common hemoglobinopathy in the world. Sickle cells are quickly fixed and destroyed by the elements of the reticuloendothelial system mainly in the spleen. It leads to a palpable increase in the volume of the spleen called splenomegaly. Splenomegaly is the cause of multiple complications that are relatively frequent and potentially serious in sickle cell disease, such as splenic sequestration seizures, spleen rupture, hypersplenism and splenic abscesses. We aimed at determining the prevalence of splenomegaly and to study the associated factors in patients with sickle cell disease. Materials and Methods: This was an analytical cross-sectional study, conducted from 1 January to 30 April 2019, at the Mother and Child Center of the Chantal BIYA Foundation. Patients were grouped into two groups: patients with splenomegaly (PS1) and patients without splenomegaly (PS0). As soon as we obtained the informed consent of the parents, we examined the children and recorded socio-demographic data, disease history and follow-up, documented complications, and clinical findings;then we performed the Rapid Malaria Diagnostic Test. The statistical analyzes were carried out using SPSS20 (Statistical Package for Social Sciences) and Microsoft Excel 2010 software. Results: We examined 403 children with sickle cell disease and 142 had splenomegaly (35%). Almost all of the study populations were homozygous SS. The Hackett 2 stage of splenomegaly was the most frequent (56.7%). The most common physical sign among PS1 was the presence of abdominal scarring (50.7% vs. 19.4%). PS1 had significantly lower levels of Hb (6.94 ± 1.67 vs 7.62 ± 1.43 p = 0.003) and platelets (297.45 ± 146.25 vs 398.70 ± 163.73 p < 0.001) than patients without splenomegaly (PS0). However, the percentages of HbF (21.78 ± 10.48 vs 15.66 ± 9.20 p < 0.001) and malaria infection (74.6% vs 17.2% p < 0.001) were statistically higher among PS0. Logistic regression analysis determine

关键词： Sickle Cell Disease Splenomegaly Thalassemia Malaria Associated Factors

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