دورية أكاديمية
أعرض في EDS

Paediatric sickle cell disease at a tertiary hospital in Malawi: a retrospective cross-sectional study.

التفاصيل البيبلوغرافية
العنوان: Paediatric sickle cell disease at a tertiary hospital in Malawi: a retrospective cross-sectional study.
المؤلفون: Chimbatata CS; Paediatrics, Mzuzu Central Hospital, Mzuzu, Northern Region, Malawi., Chisale MR; Biological Sciences, Mzuzu University Faculty of Health Sciences, Mzuzu, Northern Region, Malawi.; Laboratory, Mzuzu Central Hospital, Mzuzu, Northern Region, Malawi., Kayira AB; Laboratory, Mzuzu Central Hospital, Mzuzu, Northern Region, Malawi., Sinyiza FW; Medicine, Mzuzu Central Hospital, Mzuzu, Northern Region, Malawi., Mbakaya BC; Department of Public Health, Faculty of Applied Sciences, University of Livingstonia, Mzuzu, Northern Region, Malawi., Kaseka PU; Paediatrics, Mzuzu Central Hospital, Mzuzu, Northern Region, Malawi., Kamudumuli P; University of Maryland Global Initiatives Corporation Baltimore, Lilongwe, Central Region, Malawi., Wu TJ; Luke International, Mzuzu, Northern Region, Malawi.; Ping Tung Christian Hospital, Pingtung, Taiwan.
المصدر: BMJ paediatrics open [BMJ Paediatr Open] 2021 Sep 08; Vol. 5 (1), pp. e001097. Date of Electronic Publication: 2021 Sep 08 (Print Publication: 2021).
نوع المنشور: Journal Article; Research Support, Non-U.S. Gov't
اللغة: English
بيانات الدورية: Publisher: BMJ Publishing Group Country of Publication: England NLM ID: 101715309 Publication Model: eCollection Cited Medium: Internet ISSN: 2399-9772 (Electronic) Linking ISSN: 23999772 NLM ISO Abbreviation: BMJ Paediatr Open
أسماء مطبوعة: Original Publication: London : BMJ Publishing Group, [2017]-
مواضيع طبية MeSH: Anemia, Sickle Cell*/complications, Child ; Cross-Sectional Studies ; Humans ; Malawi/epidemiology ; Retrospective Studies ; Tertiary Care Centers
مستخلص: Introduction: Sickle cell disease (SCD) remains a major cause of childhood mortality and morbidity in Malawi. However, literature to comprehensively describe the disease in the paediatric population is lacking.
Methods: A retrospective review of clinical files of children with SCD was conducted. Descriptive statistics were performed to summarise the data. χ 2 or Fisher's exact test was used to look for significant associations between predictor variables and outcome variables (case fatality and length of hospital stay). Predictor variables that were significantly associated with outcome variables (p≤0.05) in a χ 2 or Fisher's exact test were carried forward for analysis in a binary logistic regression. A multivariable binary logistic regression was used to identify covariates that independently predicted length of hospital stay.
Results: There were 16 333 paediatric hospitalisations during the study period. Of these, 512 were patients with SCD representing 3.1% (95% CI: 2.9%- 3.4%). Sixty-eight of the 512 children (13.3%; 95% CI: 10.5% - 16.5%) were newly diagnosed cases. Of these, only 13.2% (95% CI: 6.2% - 23.6%) were diagnosed in infancy. Anaemia (94.1%), sepsis (79.5%) and painful crisis (54.3%) were the most recorded clinical features. The mean values of haematological parameters were as follows: haemoglobin (g/dL) 6.4 (SD=1.9), platelets (×10 9 /L) 358.8 (SD=200.9) while median value for white cell count (×10 9 /L) was 23.5 (IQR: 18.0-31.2). Case fatality was 1.4% (95% CI: 0.6% - 2.8%)and 15.2% (95% CI: 12.2% -18.6%) of the children had a prolonged hospital stay (>5 days). Patients with painful crisis were 1.7 (95% CI: 1.02 - 2.86) times more likely to have prolonged hospital stay than those without the complication.
Conclusion: Anaemia, sepsis and painful crisis were the most common clinical features paediatric patients with SCD presented with. Patients with painful crisis were more likely to have prolonged hospital stay. Delayed diagnosis of SCD is a problem that needs immediate attention in this setting. Although somewhat encouraging, the relatively low in-hospital mortality among SCD children may under-report the true mortality from the disease considering community deaths and deaths occurring before SCD diagnosis is made.
Competing Interests: Competing interests: None declared.
(© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
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فهرسة مساهمة: Keywords: health services research; nursing; palliative care
تواريخ الأحداث: Date Created: 20210927 Date Completed: 20220214 Latest Revision: 20220716
رمز التحديث: 20240628
مُعرف محوري في PubMed: PMC8438882
DOI: 10.1136/bmjpo-2021-001097
PMID: 34568588
قاعدة البيانات: MEDLINE
الوصف
تدمد:2399-9772
DOI:10.1136/bmjpo-2021-001097