Hospitalizations among children with sickle cell disease enrolled in the Kumasi Sickle Cell Pan African Consortium (SPARCo) database: A cross sectional study

Background and AimsSickle cell disease (SCD) is the commonest monogenic haemolytic disorder in Africa. Despite strides made in its management, a significant proportion of patients are hospitalized from the various complications of the disease. This study set out to describe the main causes and outcomes of hospitalizations among pediatric patients with SCD.MethodsA cross-sectional study was conducted at the Pediatric Emergency Unit of Komfo Anokye Teaching Hospital within a period of 12 months to recruit pediatric SCD patients. This study looked at causes of admission, length of hospital stay (LOS), and outcome of admission.ResultsOf the 201 SCD patients recruited, 57.2% were males and majority were of SCD-SS phenotype 83.1%. The median age was 6 years. The three leading causes of hospitalization were Vaso-occlusive pain events (VOPE) (39.8%), acute chest syndrome (ACS) (25.9%), and infections (12.4%). Ten (5.0%) of the patients presented with a stroke. High admissions were observed in June (12.4%) and November (16.9%). The median (interquartile range [IQR]) LOS was 6 days (IQR: 4-10). Six (3.0%) of the patients died from complications of the disease during hospitalization.ConclusionVOPE, ACS, infections, and acute anaemia from hyperhaemolysis were observed as the most common causes of admissions among SCD patients. A good outcome of discharge was seen in most of the patients that were hospitalized with a median length of stay of 6 days. This study also strengthens the importance of a good SCD database with patient follow-ups for better outcomes in SCD patients. What is known: Vaso-occlusive pain episode, ACS, infections, and anaemia are the most common causes of admissions among pediatric SCD patientsWhat's new: The study highlights the importance of timely and appropriate intervention in preventing mortality in acute chest syndrome (ACS). it also highlights the need for advanced therapy in some selected patients in SCD and the need to the review cost of these therapies.Clinical implication: Treatment of ACS in resource-limited areas requires a high index of suspicion as well as the appropriate institution of individualized therapy which includes fluid therapy, oxygen therapy, and red cell transfusion in aliquots to ensure a favorable outcome.