African Journal of Laboratory Haematology and Transfusion Science
Journal / African Journal of Laboratory Haematology and Transfusion Science / Vol. 3 No. 3 (2024) / Articles

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Published:

Nov 7, 2024

Keywords:

Cytokines, hydroxyurea, neutrophil-lymphocyte ratio, platelet-lymphocyte ratio; sickle cell anaemia

Issue

Vol. 3 No. 3 (2024)

Section

Articles

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

SK Appiah

Department of Haematology, School of Allied Health Sciences, University for Development Studies, Tamale, Ghana,

C Nkansah

Department of Haematology, School of Allied Health Sciences, University for Development Studies, Tamale, Ghana,

G Abbam

Department of Haematology, School of Allied Health Sciences, University for Development Studies, Tamale, Ghana,

F Osei-Boakye4

Department of Medical Laboratory Technology, Faculty of Applied Science and Technology, Sunyani Technical University, Sunyani, Ghana

S Daud

Department of Haematology, School of Allied Health Sciences, University for Development Studies, Tamale, Ghana,

CA Derigubah

Department of Medical Laboratory Technology, School of Applied Science and Arts, Bolgatanga Technical University, Sunyani, Ghana

C Opeabo-Sam

Department of Biomedical Laboratory Sciences, School of Allied Health Sciences, University for Development Studies, Tamale, Ghana

A Agyekum

Department of Biomedical Laboratory Sciences, School of Allied Health Sciences, University for Development Studies, Tamale, Ghana

E Osei-Osarfo

Department of Biomedical Laboratory Sciences, School of Allied Health Sciences, University for Development Studies, Tamale, Ghana

MM Tanko

Department of Biomedical Laboratory Sciences, School of Allied Health Sciences, University for Development Studies, Tamale, Ghana

S Ballu

Department of Medical laboratory & Orthopaedic, Methodist Hospital Wenchi, Bono Region, Ghana

S Chemogo

Department of Medical laboratory & Orthopaedic, Methodist Hospital Wenchi, Bono Region, Ghana

MA Gyamfi

Department of Medical laboratory & Orthopaedic, Methodist Hospital Wenchi, Bono Region, Ghana

ENO Kwadwo

Department of Medical laboratory & Orthopaedic, Methodist Hospital Wenchi, Bono Region, Ghana

S Yeboah

Department of Medical laboratory & Orthopaedic, Methodist Hospital Wenchi, Bono Region, Ghana

C Nkrumah

Department of Medical laboratory & Orthopaedic, Methodist Hospital Wenchi, Bono Region, Ghana

B Natomah

Department of Medical laboratory & Orthopaedic, Methodist Hospital Wenchi, Bono Region, Ghana

VU Usanga

Department of Medical Laboratory Science, Faculty of Health Science and Technology, Ebonyi State University, Abakaliki, Nigeria

BN Ukwah

Department of Medical Laboratory Science, Faculty of Health Science and Technology, Ebonyi State University, Abakaliki, Nigeria

EF Chukwurah

Department of Medical Laboratory Science, Faculty of Health Science and Technology, Ebonyi State University, Abakaliki, Nigeria

Abstract

Background: Immune mediators of inflammation are implicated in the pathophysiological processes and clinical variability of sickle cell anaemia (SCA). This study determined the effect of hydroxyurea therapy on markers of inflammation and clinical variability of sickle cell anaemia in Ghana.

Methods: This prospective case-control study was conducted at Methodist Hospital, Wenchi. Ninety participants (60 SCA patients and 30 apparently healthy controls (HbA)) aged 2-40 were recruited from March to July 2023. About 4 mL of blood was collected for complete blood count analysis using a Sysmex XN-550 haematology analyzer and serum C-reactive protein (CRP), interleukin (IL-6), and hepcidin using an enzyme-linked immunosorbent assay. Data were analyzed using SPSS version 27.

Results: Serum levels of IL-6 [4.7 (3.9-5.1) vs 3.0 (2.2-4.0), p<0.001], CRP [452.4±154.6 vs 267.5±84.2, p<0.001], NLR [1.4 (1.1-2.2) vs 0.9 (0.5-1.3), p<0.001], platelets [357.0 (248.5-445.5) vs 240.5 (180.5-264.5), p<0.001] and TWBC [10.3 (8.3- 12.6) vs 5.2 (4.3-5.9), p<0.001] were significantly elevated with reduction in levels of hepcidin [145.3 (109.2-185.2) vs 208.6 (150.6-246.4), p<0.001], HB [8.4±1.8 vs 12.8±1.3, p<0.001], RBC [2.6 (2.3-3.4) vs 4.5 (4.1-4.9), p<0.001] and HCT [25.6±5.4 vs 39.9±4.5, p<0.001] among SCA participants compared to the control group. However, the levels of the inflammatory markers showed significant reduction with improved haemogram in SCA participants treated with HU compared to the naïve group; [IL-6 (p=0.014), CRP (p<0.001), NLR (p=0.009), PLR (p=0.003), HB (p<0001), RBC (p=0.001), HCT (p=0.031), platelets (p<0.001), TWBC (p<0.001)]. Levels of IL-6 (rho=0.503, p<0.001), CRP (rho=0.449, p<0.001) platelets (rho=0.554, p<0.001) and TWBC (rho=0.300, p=0.020) positively correlated with disease severity. NLR, PLR and hepcidin levels showed no significant correlation with disease severity score (p>0.05).

Conclusion: In summary, hydroxyurea therapy significantly improves red cell indices and reduces inflammatory biomarkers, which minimizes the severity of sickle cell anaemia complications.

Journal Identifiers

eISSN: 2814-0605
print ISSN: 2814-0591