Age at Diagnosis of Sickle Cell Anaemia in Lagos, Nigeria

Abstract

BackgroundSickle cell anaemia is the most common genetic disorder worldwide as well as in Nigeria. Delay in the diagnosis of the condition constitutes an important cause of concern for caretakers of affected children.ObjectiveTo determine the age at diagnosis in a population of children with sickle cell anaemia in Lagos, Nigeria.MethodologyThe study was conducted between October and December 2009 at the sickle cell clinic of the Department of Paediatrics of Lagos State University Teaching Hospital, Ikeja, Lagos in South west Nigeria. By convenience sampling, a total of 192 children with sickle cell anaemia aged six months to 15 years were interviewed with the aid of a structured questionnaire.ResultsOverall, the mean age at confirmation of haemoglobin genotype was 27.33 months (± 26. 36 months). The mean age at diagnosis was significantly lower among males than females (25.59 ± 27.74 Vs. 29.14 ± 24.85, p = 0.04). A quarter of the children were diagnosed before infancy and three-quarters before three years of age. Upper social stratum and small family size were significantly associated with earlier diagnosis of sickle cell anaemia.ConclusionToo few subjects are diagnosed in infancy. Routine screening should ideally be done at birth and neonatal period or at the latest, between six and nine months.

What Factors Influence the Age at Diagnosis of Sickle Cell Anemia in Enugu, Nigeria?

“…This gender difference was also documented by Akudu et al [11] in Lagos, Nigeria. Plausible reason for this difference could be because males are more exposed to precipitating factors of crises such as strenuous exercise [12] [13] and some Asian countries [14] parents have preference for male children and therefore pay more attention to their health needs.…”

“…The reason may also be that younger mothers still have small family size and may have more resources that are channeled to the health needs of the family while older mothers with larger family size and more economic responsibilities may delay seeking health care for the family. Small family size as a factor for early diagnosis of sickle cell anemia was also documented by Akudu et al [11] in Lagos, South West Nigeria.…”

“…It has been documented [16] that well educated mothers seek and utilize the health facilities for their children more than the uneducated mothers. As noted by Akudu et al [11] and Brown et al [17] children from the upper economic strata were diagnosed earlier than those from the lower strata. It has been documented by Oyedeji et al [10] that a socioeconomic stratum of a family was dependent on maternal education among other things.…”

Rapid screening for sickle cell disease by polymerase chain reaction-high resolution melting analysis

“…Based on the results, genetic counseling and prenatal diagnosis would then be offered to the couples. Additionally, the HRM method may also be a suitable tool for mass SCD screening at the molecular level, particularly in the African areas currently lacking appropriate means for neonatal screening and early diagnosis (18). Besides, the HRM method, which is used for Hb S screening, may also be applied in malaria-associated studies.…”

Hydroxyurea therapy in adult Nigerian sickle cell disease: a monocentric survey on pattern of use, clinical effects and patient’s compliance

“…Estimates put SCD prevalence between 2 and 3%, in a population of 170 million Nigerians [2][3][4] . Low levels of awareness/ knowledge, poor case finding strategies and sub-optimal treatment continue to fuel morbidity and mortality rates in the country [5][6][7][8][9] . The introduction of novel agents such as hydroxyurea has greatly impacted on disease outcome in developed climes such as US [10][11][12][13] .…”