Age‑Related Complications among Individuals with Sickle Cell Anemia Attending a Tertiary Health Facility in Northwestern Nigeria

Abstract

Background: Sickle cell disease (SCD) is the most common monogenetic disorder worldwide. With an annual birthrate of approximately 150,000 in Nigeria, the burden is expected to increase by 75% in 2050. With improved care, patients live longer but may have more complications. This study seeks to determine the prevalence of some complications of sickle cell anemia (SCA) and how age relates to these complications. Methods: This was a 2-year retrospective review of clinic records of patients with SCA attending the hematology clinic of Barau Dikko Teaching Hospital, Kaduna State, Nigeria. Data on sex, age at last birthday, age at diagnosis of SCA, number of crises in past 6 months, proteinuria, steady‑state hemoglobin concentration, chest infections, stroke, and oxygen saturation (SPO₂ ) were collated. Statistical Analysis: Data were analyzed using SPSS version 21 (IBM Corp., 2012, Armonk NY, USA). Continuous and categorical variables were assessed using the Shapiro–Wilk test and percentages. Differences in presenting ages between variables were determined using Mann–Whitney U‑tests. Level of statistical significance was set at p ≤ 0.05. Results: A total of 109 patients were retrieved, 68.8% (75/109) were females with a median (interquartile range [IQR]) age of 22 (18, 29) years. The median (IQR) number of crises in the preceding 6 months was  0 (0, 3). The prevalence of proteinuria, chest infections in the preceding 6 months, severe anemia, low oxygenation, and stroke were 9.5% (4/42), 6.5% (5/77), 7.0% (5/71), 58.9% (33/56), and 1.3% (1/77), respectively. A positive correlation existed between number of crises and presenting age (r = 0.317; p = 0.005). Patients with proteinuria, severe anemia, chest infections, and low SPO₂ had higher mean rank presenting age while patients with stroke had lower mean rank presenting age. Conclusion: Older age is significantly associated with severity of SCD. Age-targeted interventions guided by evidence-based practices are important in slowing down disease progression and severity.