Deaths in children with sickle cell disease in a pediatrics department in Central Africa

Background. - Sickle cell disease is a serious public health problem in Gabon with a relatively high mortality rate. Patients and methods, - Charts of 23 children (nine boys, 14 girls) who died of complications from sickle cell anemia in the department of pediatrics of Owendo Pediatric Hospital (Libreville, Gabon), from January 1, 1990 through December 31, 1992, were analysed retrospectively. Results. - Approximately two-thirds of the children (60.9%) were under 5 years of age. The great majority of patients were from low socio-economic standard families. Of 319 deaths observed during the study period 23 were due to sickle cell disease-associated complications for an overall mortality rare of 7.2% and a related mortality of 3.6%. Commonest causes of deaths were severe anemia (11 cases, ie, 47.8%), which affected predominantly the younger patients between 6 months and 5 years (eight cases), infections (30.4%) and blood transfusion complications (21.7%). Conclusion. - To decrease these mortality rates, appropriate health supervision and well-designed preventive strategies are needed. (C) 1998 Elsevier, Paris.