Risk Factors and Outcome of Overt Stroke in Sickle Cell Patients Admitted in Two Reference Hospitals in Yaounde and Douala

Abstract

Background: Worldwide, the prevalence of sickle cell disease (SCD) as of 2016 was estimated at 2%; that is 300,000 births annually. This study was focused on homozygous sickle cell disease which leads to several complications notably hemolytic crises, aplastic crises and vaso-occlusive crises like stroke. Sickle cell disease is the most common cause of childhood stroke. Stroke occurs in 17% -24% of sickle cell children worldwide. Objectives: To determine the risk factors for overt stroke and outcome at discharge in sickle cell disease patients admitted in two reference hospitals in Cameroon. Method: This was a case-control study in two reference hospitals in Yaounde and Douala, carried out over the duration of 4 months, covering a 5-year period (December 2013 to December 2018). Included in the study, were all homozygous sickle cell children aged 6 months to 16 years during that period with or without stroke. A total of 1734 patients fulfilled the inclusion criteria. Out of these, 49 stroke patients participated and 687 were selected as controls. Data was collected from the patients' files and books on a pretested data collection form, then entered in the software C.S Pro 7.1 before analysis. Stroke outcome at discharge was assessed using the modified Rankin scale (mRs) with structured interview. A patient was classified as good outcome if mRs < 3 and poor outcome if mRs ≥ 3. Statistical analysis was done with SPSS software version 22.

Exploring Factors Associated with Quality of Life in Caregivers of Children and Adolescents with Sickle Cell Disease and HIV: A Comparative Analysis

“…Mwangala et al [ 49 ] also reported that caregiver's age and secondary level of education negatively influence the QoL of caregivers, while Van den tweel [ 9 ] additionally reported that limitation in daily activities and vitality negatively influenced QoL. SCD is a chronic disease, which may lead to debilitating complications like stroke [ 3 , 51 , 52 ] and femoral osteonecrosis [ 53 , 54 ] which could significantly impair patient's mobility and autonomy making them fully dependent on caregivers. In addition, the intensity of pain crises may cause insomnia and psychological distress in caregivers, which may affect their quality of life [ 55 ].…”

“…Sickle cell disease (SCD) is one of the most common genetic blood disorders [1]. It manifests clinically as painful vasoocclusive crises and chronic haemolytic anemia with episodes of acute worsening and bacterial infections, causing heavy morbidity and mortality in countries with limited resources [2][3][4]. According to available evidence, Nigeria is believed to have the highest number of individuals afected by sickle cell disease on a global scale [5].…”