Major acute pain complications in Congolese children with sickle cell disease

Abstract

Sickle cell disease is the most frequent genetic blood disorder in the world and pain complications are the most prominent clinical aspects in sickle cell population.

Objectives: Describe the morbidity feature of major acute pain complications in children with sickle cell disease and outcome.

Material and Methods: 166 sickle cell disease children (4.3%) with a mean age of 85.31 months old±60.40 admitted in the pediatric intensive care unit for major acute pain complications were enrolled in the study from January to December 2014. Major acute pain complications were defined as acute sickle cell related pain with an intensity assessed at 3 on the Wong-Baker faces pain rating scale. 

Results:  Over the period study, 118 patients were admitted for diffuse vaso occlusive crisis (70.09%). Localized vaso occlusive crisis occurred in 13.25%, acute chest syndrome in 09.64% and hand foot syndrome in 06. 02%. The most common trigger factors were bacterial infections (65.12%) followed by malaria (34.88%). Mortality of 12.05% was recorded while 27.71% were discharged and 60.24% transferred to other departments. The mortality rate was significantly higher in the range age over 5 years (p=0.004)

Keywords

• Sickle cell disease,Major acute pain; Intensive care department; Congo

Major acute pain complications in Congolese children with sickle cell disease Lydie Ocini Ngolet1*, Moyen Engoba2, Alexis Elira Dokekias1, Kocko Innocent1, George Moyen2

Öz

Kaynakça

1. Piel FB, Patil AP, Howes RE, Ngangiri AO, Gething PW, Dewi M, et al. Global epidemiology of sickle hemoglobin in neonates: a contemporary geostatistical model-based map and population estimates. Lancet 2013;38(9861): 142-51.
2. Piel FB, Hay SI, Gupta S, Weatherall DJ, William TN. Global burden of sickle anemia in children under five, 2010-2050: modeling based on demographics, excess mortality, and intervention. Plos 2013; 10(7): e1001484.
3. Rees DC, William TN, Gladwin MT. Sickle cell disease. Lancet 2010; 376: 2018-31.
4. Williams TN, Obaro SK. Sickle cell disease and malaria morbidity: a tale with two tails. Trands Parasitol 2011; 27(7): 315-2
5. Abhulimhen-Iyoha BI, Israel-Aina YT, Okolo AA. Haemoglobin phenotypes of patients admitted to the children emergency room of the university of Benin Teaching Hospital, Benin city, Edo state, Nigeria. Journal of Medicine and Biomedical Research. 2013;12(1):11-6.
6. Mpemba Loufoua AB, Makoumbou P, Mabiala Babela JR, et al. Dépistage néonatal de la drépanocytose au Congo Brazzaville. Ann Univ Marien Ngouabi 2010; 11(5): 21-5.
7. Mouele R, Boukila V, Fourcade V, Feingold J, Galacteros F. Sickle cell disease in Brazzaville, Congo: genetical haematological, biochemical and clinical aspects. Acta Haematol 1959; 101: 178-84.
8. Ballas SK, Lieff S, Benjamin LJ, Dampier CD, Heeney MM, Hoppe C, et al. Definitions of the phenotypic manifestations of sickle cell disease. Am J Hematol 2010; 85(1): 6-13.

9. Al-Saqladi AW, Delpisheh A, Bin-Gadeem H and Bradin BJ. Clinical profile of sickle cell disease in Yemeni children. Annals of Tropical Paediatrics 2007; 4(27): 253-9.
10. Mabiala Babela JR, Nzingoula S, Senga P. Les crises vaso-occlusives drépanocytaires chez l’enfant et l’adolescent à Brazzaville, Congo. Etude rétrospective de 587 cas. Bull Soc Pathol Exot 2005 ; 98(5) : 365-70.
11. Elira –Dokekias A. Etude des facteurs analytiques de la maladie drépanocytaire au Congo. Med Afr Noire 1996 ; 43(5): 279-84.
12. Mbika A Cardorelle, Okoko A, Mouko A. Les crises vaso-occlusives de l’enfant drépanocytaire à Brazzaville. Arch Pédiatr 2010; 17; 295-6.
13. Mabiala Babela JR Nkanza-Kaluwako AT, Ganga-Zandzou, Nzingoula S, Senga P. Causes d’hospitalisation des enfants drépanocytaires : influence de l’âge (C.H.U. de Brazzaville, Congo). Santé Publique 2005 ; 2767 : 392-3.
14. Anyanwu OU, Ezeanosike OB, Ezeand CT. Pattern and outcome of admission at the children emergency room at the Federal Teaching Hospital Abakaliki. Afr J med Health Sci 2014; (13)1:6-10.
15. Jaiyesmi F, Pandey R, Bux D, Sreekrishna Y, Zaki F and, Krishnamoorthy. Sickle cell morbidity profile in Omani children. Annals of Tropical Paediarics 2002; (22)1 : 45-52.
16. Ikefuna AN, Emodji J. Hospital admission of patients with sickle cell anemia pattern and outcome in Enugu area of Nigeria. Niger J Clin Pract 2007; 10(1): 249.
17. Diagne I, Ndiaye O, Moreira C et al. Les syndromes drépanocytaires majeurs en pédiatrie à Dakar (Sénégal). Arch Pédiatr 2000; 7 :16-24.
18. Tshilolo L, Wembonyama S, Summa V, Avvisati G. L’hémogramme de l’enfant drépanocytaire Congolais au cours des phases stationnaires. Med trop 2010 ; 70 : 459-63.
19. Diarra Y, Fla K, Lassina D et al. Prise en charge de la drépanocytose en milieu pédiatrique : expérience du centre hospitalier universitaire pédiatrique Charles-de-Gaulle de Ouagadougou (Burkina Faso). Cahiers santé 2008 ; 2(18) : 71-4.
20. Thuillez V, Ditsamou V, Mba JR, Mba Meyo S, Kitengue J. Aspects actuels de la drépanocytose chez l’enfant au Gabon. Arch Pédiatr 1996; 3(7); 668-74.
21. Organisation Mondiale de la Santé. Rapport annuel de lutte contre la maladie. Congo 2012.
22. Latoundji S, Anani L, Abet E et al. Morbidité et mortalité drépanocytaire au Bénin. Med Afr Noire 1991 ; 38 : 571-6JP, Maiza ,Choma R, Farouq G, Machokoy Y. West Afr J Med 2012; Apr-Jun; 31(2): 81-5.
23. Makani J, Komba N, Cox SE et al. Malaria in patients with sickle cell anemia : burden, risk factors, and outcome at the outpatient clinic and during hospitaization. Blood 2010; 115(2): 215-20.
24. De Montalembert D, Guillou-Bataille M, Feingold J, Girot R. Epidemiological and clinical study of sickle cell disease in France, French Guiana and Algeria. Eur J Haematol 1993; 51: 136-40.
25. Vichinsky EP, Neumayr LD, Earles AN et al. Cause and outcomes of the acute chest syndrome in sickle cell disease. N engl J Med, 2000; 342: 1855-65.
26. Labie D, Elion J. Génétique et physiopathologie de la drépanocytose. In « La drépanocytose ». John Libbey Eurotext ed. Paris, 2003 :1-11.
27. Athale UH, Chintu C. Clinical analysis of mortality in hospitalized Zambian children with sickle cell anaemia. East Afr Med J 1994; 71: 388-91.