Frequency and factors associated with hospitalization of children with sickle cell anaemia (SCA) at two tertiary centres in Kenya

Abstract

Objective: The aim of this study was to determine the frequency and the key factors associated with hospitalization of patients with sickle cell disease in children below 18 years of age.

Study design, setting and duration: A descriptive cross-sectional study carried out in Kenya at a public tertiary referral facility and a private tertiary facility. Study participants were selected by consecutive sampling from the Hematology clinics at both institutions between November 2017-February 2018

Subjects: Children below 18 years of age with a diagnosis of sickle cell anemia (SCA) confirmed by serum haemoglobin (Hb) electrophoresis, informed consent from the parent/guardian and assent for older children. Children were excluded if diagnosed with sickle cell trait, α or β-thalassemia.

Outcomes: Frequency of hospitalizations in the past 1 year for any sickle cell crises and factors affecting this hospitalization.

Results: The median age of study group was 10 years (IQR 8-11). Seventy six percent (76%) of the children with SCA had at least one episode in the last one year. Majority of children (82.9%) above 5 years were underweight with a mean BMI 15.46. Risk factors statistically significant for frequent hospitalization were children at post primary level of education OR 15.4(4.27-55.6, p-value <0.001) and lack of follow up OR 4.26(1.70-10.66, p-value <0.001).

Conclusion: This study shows there is a high frequency of hospitalization in children with sickle cell anemia between 0 years and 18 years. Follow up remains an important aspect in the care of children with SCA with children at post primary level of education requiring more attention.