Presentations of sickle cell disease patients to hospital in Ghana: key findings from a preliminary study at Volta Regional Hospital

Fisher, Amelia E.; Oduro, Augustine K. Y.; Festus, Adzaku; Telfer, Paul

doi:10.1111/bjh.14154

Cited by 3 publications

(6 citation statements)

References 5 publications

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“…In Africa, malaria and SCD are prevalent [26] and their co-morbidity have been reported in Ghana [27]. However, there is paucity of data on clinical manifestations, haematological profiles and degree of oxidative stress in SCD and malaria co-morbidities.…”

Section: Introductionmentioning

confidence: 99%

Haematological parameters and plasma levels of 8-iso-prostaglandin F2α in malaria-sickle cell co-morbidity: A cross sectional study

Aninagyei

Tetteh

Banini³

et al. 2018

Preprint

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23Introduction 24 Malaria and sickle cell disease (SCD) co-morbidity have previously been reported in Ghana. 25 However, there is paucity of data on haematological profiles and oxidative stress in co-26 morbidity states. This study identified novel inflammatory biomarkers associated with malaria 27 in SCD and analyzed the levels of 8-iso-prostaglandin F2α oxidative stress biomarker in malaria-28 SCD co-morbidity in Ghanaian patients. 29 Methods 30 Blood (5ml) was collected from malaria patients into K 3 -EDTA tube. Malaria parasites speciation 31 and quantification were then done according WHO guidelines. All eligible samples were assayed 32 for haematological profile, sickle cell phenotyping, infectious markers (hepatitis B, hepatitis C, 33 syphilis and HIV 1&2) and plasma levels of 8-epi-prostaglandin F2α. . 35 Results 36Prevalence of malaria in SCD (malaria-SCD) was 13.4% (45/335). Male: female ratio was 0.8:1 37 (X 2 =1.43, p=0.231). Mean ages for malaria in normal haemoglobin type (malaria-HbAA) and 38 malaria-SCD were 12.79±4.91 and 11.56±3.65 years respectively (p=0.048). Geometric mean of 39 parasite density was higher in malaria-HbAA (20394 parasites/µl vs. 9990 parasites/µl, p=0.001) 40 whilst mean body temperature was higher in malaria-SCD (39.0±0.87°C vs. 37.9±1.15°C, 41 p=0.001). Mean leukocytes, lymphocytes, eosinophils, monocytes, platelets and platelet indices 42 values were significantly elevated in malaria-SCD. Significant reduction in RBC and RBC indices 3 43 in malaria-SCD were also observed. Eosinophils-to-basophils ratio (EBR) and monocytes-to-44 basophils ratio (MBR) were novel cellular inflammatory biomarkers which could predict malaria 45 in SCD. The sensitivities of cut-off values of EBR>14, MBR>22 and combined use of EBR>14 and 46 MBR>22 were 79.55%, 84.09% and 91.11% respectively. Mean 8-iso-prostaglandin F2α was 47 338.1pg/ml in malaria-HbAA and 643.8pg/ml in malaria-SCD (p=0.001). 8-iso-prostaglandin F2α 48 correlated with parasite density (r=0.787, p=0.001), temperature (r=0.566, p=0.001) and 49 leucocytes (r=0.573, p=0.001) and negatively correlated with RBC (r=-0.476, p=0.003), 50 haemoglobin (r=-0.851, p=0.001) and haematocrit (r=-0.735, p=0.001). 51 52 Conclusion 53 Plasmodium falciparum parasitaemia increases oxidative damage and causes derangement 54 haematological parameters. Cut of values of EBR>14 and MBR>22 could predict malaria in SCD. 55 Keywords: 8-epi-prostaglandin F2α, oxidative stress, haematological profile, malaria-SCD co-56 morbidity, eosinophils-to-basophils ratio, monocytes-to-basophils ratio 57 58 59 4 63 as level of malaria endemicity, presence of haemoglobinopathies, nutritional status and level of 64 malaria immunity [5, 6]. Malaria is meso-endemic in Ghana with recent nationwide prevalence 65 of 43.4% [7]. Sickle cell disease (SCD) resulting from two haemoglobin S (HbS) haplotypes 66 (HbSS) and heterozygote sickle cell phenotype resulting from one HbS haplotype and one 67 haemoglobin C (HbC) haplotype (HbSC) is also prevalent in Ghana [...

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Section: Introductionmentioning

confidence: 99%

Haematological parameters and plasma levels of 8-iso-prostaglandin F2α in malaria-sickle cell co-morbidity: A cross sectional study

Aninagyei

Tetteh

Banini³

et al. 2018

Preprint

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“… 3 Furthermore, a study in Ghana reported a SCD miscarriage rate of up to 37.2%, which is nearly twice the miscarriage rates reported in non‐SCD pregnant women in other sub‐Saharan African countries. 4 This highlights the fact that SCD patients have a decreased ability to conceive and a high chance of having a miscarriage after a successful conception. It also highlights how rare it is to have pregnant SCD patients, especially those with multiple pregnancies successfully going through the entire gestation to term and later delivery without adverse outcomes.…”

Section: Sickle Cell Disease and Sub‐fertilitymentioning

confidence: 99%

“…This highlights the fact that SCD patients have a decreased ability to conceive and a high chance of having a miscarriage after a successful conception. It also highlights how rare it is to have pregnant SCD patients, especially those with multiple pregnancies successfully going through the entire gestation to term and later delivery without adverse outcomes 4 . This was the case of the index patient, who had two previous miscarriages and had a twin pregnancy.…”

Section: Sickle Cell Disease and Sub‐fertilitymentioning

confidence: 99%

“…The diminished ovarian reserve and other SCD‐mediated ovarian damage could eventually result in the impairment of ovulation, fertilization, and implantation, thereby causing subfertility 3 . Furthermore, a study in Ghana reported a SCD miscarriage rate of up to 37.2%, which is nearly twice the miscarriage rates reported in non‐SCD pregnant women in other sub‐Saharan African countries 4 . This highlights the fact that SCD patients have a decreased ability to conceive and a high chance of having a miscarriage after a successful conception.…”

Section: Sickle Cell Disease and Sub‐fertilitymentioning

confidence: 99%

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Preterm management of sickle cell crisis in a twin pregnancy with suboptimal antenatal care in a primary healthcare facility: A case report from Cameroon and literature review

Tih,

Takang,

Egbe

2023

Clinical Case Reports

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Key Clinical MessageTwin pregnancies in homozygous sickle cell patients are not only uncommon in our setting but are most often associated with adverse maternal–fetal outcomes especially in primary healthcare facilities where most of these cases initially present due to financial constraints, though lacking the necessary technical platform (including blood banks) to properly manage them.AbstractWe are reporting the case of the preterm management of sickle cell crises in a twin pregnancy with poor antenatal care uptake in a primary healthcare facility devoid of a blood bank in Cameroon. Ngungi Fely, a 21‐year‐old HbSS patient, of the Bakweri tribe G3P0020, blood group O rhesus positive, was admitted at our health facility at 33 3/7 weeks' gestation with twin pregnancy, clinical anemia (hemoglobin 3.3 g/dL), the pulse rate of 123 beats/min, the respiratory rate of 38 breaths per min, the temperature of 39.2°C, and altered state of consciousness. She has a history of two spontaneous abortions (16 and 18 weeks’ gestation) and has attended three antenatal care (ANC) visits (18, 24, and 28 weeks’ gestation) for the index pregnancy. She underwent cesarean delivery of two live‐born babies at 35 4/7 weeks' gestation and received 9 units of compatible blood (before, during, and after the cesarean) partly with the help of the “Blood Track Program” (which uses text messages to seek blood donors). The babies were referred to a secondary healthcare facility and the mother and babies' outcomes were uneventful. Sickle cell disease (SCD) in pregnancy is difficult to manage in primary care settings in Cameroon because of a poor technical platform. A multidisciplinary approach to the management of SCD in pregnancy is the mainstay in secondary and tertiary healthcare centers. The “Blood Track Program” is a good initiative that should be extended nationwide in Cameroon to reduce the burden of acquiring blood for transfusion, particularly in primary care centers devoid of blood banks.

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“…SCD is a genetic disorder that affects both children and adults [16-18] and is known to be more common within the Sub-Saharan Africa compared to other parts of the world [18]. In Ghana, SCD is linked to high rate of mortality and morbidity, with prevalence of about 1.6% [19]. It has been reported that 25-30% of the Ghanaian adults are carriers of the sickle cell trait and 2% of babies have SCD [20, 21].…”

Section: Introductionmentioning

confidence: 99%

Sex differences in physical activity among Ghanaian patients with sickle cell disease

Nyante¹,

Oppong²,

Bonney³

2019

Pan Afr Med J

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Introduction Musculoskeletal pain and functional limitations experienced by patients with Sickle Cell Disease (SCD) impact their physical activity and social behaviour. Yet, we know little about physical activity behaviour in patients with SCD. The aim of this study was to investigate gender differences in physical activity, sedentary time and measures of fitness among Ghanaian adults with SCD. The study also determined the association between outcome variables in this population. Methods Patients with SCD attending a sickle cell clinic in a tertiary hospital in Accra, Ghana participated in this cross-sectional study. Physical activity, sedentary time, body composition, flexibility and cardiovascular endurance were assessed. Demographic data were also collected by self-report. Results Fifty three participants enrolled in the study. Of these, more than half were females (60.4%) and the average age of the participants was (M: 26.8, SD: 8.5 years). The total physical activity reported by the participants was different between males and females (t = 2.610, p = 0.012). However, there were no gender differences in sedentary time, body composition, flexibility and cardiovascular endurance. A moderately significant association was found between sedentary time and cardiovascular endurance (r = 0.437, p = 0.001). Conclusion The findings suggest that gender differences in physical activity are apparent in patients with SCD. Investigations into the mechanisms underpinning these differences are warranted. Additionally, longitudinal observations of objectively measured physical activity may be useful to validate these results in a larger sample.

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Presentations of sickle cell disease patients to hospital in Ghana: key findings from a preliminary study at Volta Regional Hospital

Cited by 3 publications

References 5 publications

Haematological parameters and plasma levels of 8-iso-prostaglandin F2α in malaria-sickle cell co-morbidity: A cross sectional study

Haematological parameters and plasma levels of 8-iso-prostaglandin F2α in malaria-sickle cell co-morbidity: A cross sectional study

Preterm management of sickle cell crisis in a twin pregnancy with suboptimal antenatal care in a primary healthcare facility: A case report from Cameroon and literature review

Sex differences in physical activity among Ghanaian patients with sickle cell disease

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