1
|
Kasai ET, Alworong’a Opara JP, Ntokamunda Kadima J, Kalenga M, Batina Agasa S, Marini Djang’eing‘a R, Boemer F. Overview of current progress and challenges in diagnosis, and management of pediatric sickle cell disease in Democratic Republic of the Congo. Hematology 2022; 27:132-140. [DOI: 10.1080/16078454.2021.2023399] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Emmanuel Tebandite Kasai
- Department of Pediatrics, Faculty of Medicine and Pharmacy, University of Kisangani, Kisangani, Democratic Republic of the Congo
| | - Jean Pierre Alworong’a Opara
- Department of Pediatrics, Faculty of Medicine and Pharmacy, University of Kisangani, Kisangani, Democratic Republic of the Congo
| | - Justin Ntokamunda Kadima
- Department of Pharmacy, Faculty of Medicine and Pharmacy, University of Kisangani, Kisangani, Democratic Republic of the Congo
| | - Masendu Kalenga
- Department of Pediatrics, Faculty of Medicine, University of Liege, Liege, Beligium
| | - Salomon Batina Agasa
- Department of Internal Medicine, Faculty of Medicine and Pharmacy, University of Kisangani, Kisangani, Democratic Republic of the Congo
| | - Roland Marini Djang’eing‘a
- Department of Pharmacy, Faculty of Medicine and Pharmacy, University of Kisangani, Kisangani, Democratic Republic of the Congo
- Laboratory of Analytical Pharmaceutical Chemistry, Faculty of Medicine, University of Liege, Liege, Belgium
| | - François Boemer
- Biochemical Genetics Laboratory, Human Genetics, CHU of Liege, University of Liège, Liege, Belgium
| |
Collapse
|
2
|
Esoh K, Wonkam-Tingang E, Wonkam A. Sickle cell disease in sub-Saharan Africa: transferable strategies for prevention and care. Lancet Haematol 2021; 8:e744-e755. [PMID: 34481550 DOI: 10.1016/s2352-3026(21)00191-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2020] [Revised: 05/27/2021] [Accepted: 06/10/2021] [Indexed: 12/22/2022]
Abstract
Sickle cell disease can be life-threatening or chronically debilitating for both children and adults. Worldwide, more than 300 000 children are born with sickle cell disease every year, over 75% of whom in sub-Saharan Africa. Increased awareness and early interventions, such as neonate screening and comprehensive care, have led to considerable reductions in mortality in children younger than 5 years in high-income countries. However, sickle cell disease prevention and care have largely been neglected in Africa. Without intervention, 50-90% of affected children in many sub-Saharan African countries die before their fifth birthday. Fortunately, increasing initiatives in sub-Saharan Africa are piloting interventions such as neonate screening and comprehensive care, and as mortality declines, quality of life and increased life expectancy become major targets for interventions. Hydroxyurea (hydroxycarbamide) and haematopoietic stem-cell transplantation have already been shown to be effective therapies in high-income countries, but are either not widely accessible or too expensive for most African populations. These challenges are being alleviated by numerous networks evolving through international collaborations that are positively changing the outlook of sickle cell disease management in sub-Saharan Africa. In this Series paper, we describe the epidemiology, pathophysiology, clinicobiological profile, and psychosocial effects of sickle cell disease in sub-Saharan Africa. We highlight transferable strategies already used for the successful management of the condition and key strategies and recommendations for affordable and comprehensive care on the continent. TRANSLATION: For the French translation of the abstract see Supplementary Materials section.
Collapse
Affiliation(s)
- Kevin Esoh
- Division of Human Genetics, Department of Pathology, University of Cape Town, Cape Town, South Africa
| | - Edmond Wonkam-Tingang
- Division of Human Genetics, Department of Pathology, University of Cape Town, Cape Town, South Africa
| | - Ambroise Wonkam
- Division of Human Genetics, Department of Pathology, University of Cape Town, Cape Town, South Africa; Department of Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.
| |
Collapse
|
3
|
Mbiya BM, Kalombo DK, Mukendi YN, Daubie V, Mpoyi JK, Biboyi PM, Disashi GT, Gulbis B. Improvement of SCD morbimortality in children: experience in a remote area of an African country. BMC Health Serv Res 2021; 21:294. [PMID: 33794895 PMCID: PMC8017617 DOI: 10.1186/s12913-021-06286-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Accepted: 03/16/2021] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Sickle cell disease (SCD) is a public health problem in the Democratic Republic of Congo. While reference sickle cell centers have been implemented in capital cities of African countries and have proven to be beneficial for SCD patients. In the Democratic Republic of Congo, they have never been set up in remote areas for families with low or very low sources of income. METHOD A cohort of 143 children with SCD aged 10 years old (IQR (interquartile range): 6-15 years) (sex ratio male/female = 1.3) were clinically followed for 12 months without any specific intervention aside from the management of acute events, and then for 12 months with a monthly medical visit, biological follow-up, and chemoprophylaxis (folic acid/penicillin), adequate fluids and malaria prevention. RESULTS The median age of patients at the diagnosis of SCD was 2 years (IQR: 1-5). The implementation of standardized and regular follow-ups in a new sickle cell reference center in a remote city showed an increase in the annual mean hemoglobin level from 50 to 70 g/L (p = 0.001), and a decrease in the lymphocyte count and spleen size (p < 0.001). A significant decrease (p < 0.001) in the average annual number of hospitalizations and episodes of vaso-occlusive crises, blood transfusions, infections, and acute chest syndromes were also observed. CONCLUSIONS The creation of a sickle cell reference center and the regular follow-up of children with sickle cell disease are possible and applicable in the context of a remote city of an African country and represent simple and accessible measures that can reduce the morbimortality of children with sickle cell disease.
Collapse
Affiliation(s)
- Benoît Mukinayi Mbiya
- Pediatrics Department, Faculty of Medicine, University of Mbujimayi, 06201, Mbujimayi, Democratic Republic of Congo
- Sickle Cell Reference Center, Clinique Pédiatrique de Mbujimayi, Pediatrics Clinic of Mbujimayi, 06201, Mbujimayi, Democratic Republic of Congo
| | - Didier Kalenda Kalombo
- Pediatrics Department, Faculty of Medicine, University of Mbujimayi, 06201, Mbujimayi, Democratic Republic of Congo
- Sickle Cell Reference Center, Clinique Pédiatrique de Mbujimayi, Pediatrics Clinic of Mbujimayi, 06201, Mbujimayi, Democratic Republic of Congo
| | - Yannick Nkesu Mukendi
- Pediatrics Department, Faculty of Medicine, University of Mbujimayi, 06201, Mbujimayi, Democratic Republic of Congo
- Sickle Cell Reference Center, Clinique Pédiatrique de Mbujimayi, Pediatrics Clinic of Mbujimayi, 06201, Mbujimayi, Democratic Republic of Congo
| | - Valery Daubie
- Clinical Biology Department, LHUB-ULB, Université Libre de Bruxelles, 1070, Brussels, Belgium
| | - John Kalenda Mpoyi
- Sickle Cell Reference Center, Clinique Pédiatrique de Mbujimayi, Pediatrics Clinic of Mbujimayi, 06201, Mbujimayi, Democratic Republic of Congo
| | - Parola Mukendi Biboyi
- Sickle Cell Reference Center, Clinique Pédiatrique de Mbujimayi, Pediatrics Clinic of Mbujimayi, 06201, Mbujimayi, Democratic Republic of Congo
| | - Ghislain Tumba Disashi
- Internal Medicine Department, Faculty of Medicine, University of Mbujimayi, 06201, Mbujimayi, Democratic Republic of Congo
| | - Béatrice Gulbis
- Clinical Chemistry Department, Hereditary Red Blood Cell Disorders, LHUB-ULB, Université Libre de Bruxelles, 1070, Brussels, Belgium.
| |
Collapse
|
4
|
Kasai ET, Opara JPAA, Agasa SB, Gulbis B, Uvoya NA, Nguma JDB, Maloba PK, Hubert P, Etienne AM, Djang Eing A RM. [Acceptability of neonatal screening of the sickle cell disease during the pandemic of COVID-19 in Kisangani, Democratic Republic of the Congo]. Pan Afr Med J 2021; 37:299. [PMID: 33654518 PMCID: PMC7881920 DOI: 10.11604/pamj.2020.37.299.26654] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2020] [Accepted: 11/11/2020] [Indexed: 11/23/2022] Open
Abstract
Introduction l´implémentation du dépistage néonatal de la drépanocytose pendant la pandémie de coronavirus (COVID-19) représente un défi majeur en République Démocratique du Congo (RDC). La présente étude vise à déterminer si des facteurs socio-économiques sont associés à l´acceptabilité du dépistage néonatal de la drépanocytose pendant la COVID-19 à Kisangani, en RDC. Méthodes étude observationnelle conduite dans les maternités de Kisangani du 21 mars au 30 juin 2020 chez les mères sensibilisées au dépistage néonatal de la drépanocytose de leurs nouveau-nés à l´hemotypeSCTM (HT401RUO-USA). Les données recueillies étaient la parité, le niveau d´étude, l´âge, le niveau socio-économique, la profession, la notion de sensibilisation et le motif du refus du dépistage. Résultats sur 55,5% (273/492) des mères sensibilisées, 107 (39,19 %) ont accepté et 166 (60,80 %) ont refusé le dépistage néonatal de la drépanocytose chez leur nouveau-né. Les motifs du refus étaient l´absence d´information (67,5%; IC 95% [59,8-74,5]), le manque d´argent dû au confinement (66,3%; IC 95% [58,5-73,4]), la prise de sang pour tentative du vaccin anti-COVID-19 (63,2%; IC 95% = [55,4-70,6]). Les facteurs associés à l´acceptabilité du dépistage étaient l´âge > 35 ans (p = 0,0009; ORa = 3,04; IC 95% = 1,57-5,87) et le bas niveau socio-économique (p = 0,0016; ORa = 2,29; IC à 95% = 1,37-3,85). Conclusion l´acceptabilité du dépistage néonatal de la drépanocytose pendant la COVID-19 reste faible à Kisangani. Le gouvernement devrait identifier les canaux de communication efficaces afin de promouvoir les initiatives dans le secteur de la Santé.
Collapse
Affiliation(s)
- Emmanuel Tebandite Kasai
- Département de Pédiatrie, Faculté de Médecine et de Pharmacie, Université de Kisangani, Kisangani, République Démocratique du Congo
| | - Jean Pierre Alworong A Opara
- Département de Pédiatrie, Faculté de Médecine et de Pharmacie, Université de Kisangani, Kisangani, République Démocratique du Congo
| | - Salomon Batina Agasa
- Département de Médecine Interne, Faculté de Médecine et de Pharmacie, Université de Kisangani, Kisangani, République Démocratique du Congo
| | - Béatrice Gulbis
- Département de Chimie Clinique, Hôpital Erasme, Université Libre de Bruxelles, Bruxelles, Belgique
| | - Naura Apio Uvoya
- Département de Pédiatrie, Faculté de Médecine et de Pharmacie, Université de Kisangani, Kisangani, République Démocratique du Congo.,Département de Pédiatrie, Faculté de Médecine, Université de Bunia, Bunia, République Démocratique du Congo
| | - Jean Didier Bosenge Nguma
- Département de Gynécologie-Obstétrique, Faculté de Médecine et de Pharmacie, Université de Kisangani, Kisangani, République Démocratique du Congo
| | - Philippe Kasongo Maloba
- Département de Psychologie, Faculté de Psychologie et des Sciences de l´Education, Université de Lubumbashi, Lubumbashi, République Démocratique du Congo
| | - Philippe Hubert
- Laboratoire de Chimie Analytique Pharmaceutique, Center for Interdisciplinary Research on Medicines (CIRM), Faculté de Médecine, Université de Liège, Liège, Belgique
| | - Anne-Marie Etienne
- Unité de Psychologie de la Santé, Faculté de Psychologie, Logopédie et Sciences de l´Education, Université de Liège, Liège, Belgique
| | - Roland Marini Djang Eing A
- Laboratoire de Chimie Analytique Pharmaceutique, Center for Interdisciplinary Research on Medicines (CIRM), Faculté de Médecine, Université de Liège, Liège, Belgique.,Département de Pharmacie, Faculté de Médicine et de Pharmacie, Université de Kisangani, Kisangani, République Démocratique du Congo
| |
Collapse
|
5
|
Ladu AI, Aiyenigba AO, Adekile A, Bates I. The spectrum of splenic complications in patients with sickle cell disease in Africa: a systematic review. Br J Haematol 2020; 193:26-42. [PMID: 33161568 DOI: 10.1111/bjh.17179] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 09/15/2020] [Accepted: 09/16/2020] [Indexed: 01/31/2023]
Abstract
The majority of the global population of sickle cell disease (SCD) patients resides in Africa. Individuals with this condition are at great risk of serious infections and early mortality secondary to splenic dysfunction without preventative measures. This review investigated the spectrum of splenic complications encountered in SCD among populations in Africa. We systematically searched several databases for all articles published through March 3, 2020. We included 55 studies from 14 African countries. This review reveals the difference in frequency of splenic complications in SCD in Africa when compared with their counterparts in the United State and Europe. While several studies (n = 45) described splenomegaly with a prevalence of 12% to 73% among children, and 4% to 50% among adults with HbSS, the reported prevalence for acute splenic sequestration crisis (n = 6 studies) and hypersplenism (n = 4 studies) was <10% and <5% respectively. A total of 30 surgical splenectomy was reported across eight studies. Only two (3.7%) studies provided data on spleen function. A conflicting pattern was observed amongst studies that evaluated the relationship between splenomegaly and the presence of bacterial and malaria infections. This review reveals the paucity of studies describing the role of SCD-induced splenic dysfunction in morbidity and infection related mortality in Africa.
Collapse
Affiliation(s)
- Adama I Ladu
- Department of International Public Health, Capacity Research Unit, Liverpool School of Tropical Medicine, Liverpool, UK.,Department of Haematology, Faculty of Basic Clinical Sciences, University of Maiduguri, Maiduguri, Borno State, Nigeria
| | - Abiola O Aiyenigba
- Department of International Public Health, Capacity Research Unit, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Adekunle Adekile
- Department of Pediatrics, Kuwait University, Kuwait City, Kuwait
| | - Imelda Bates
- Department of International Public Health, Capacity Research Unit, Liverpool School of Tropical Medicine, Liverpool, UK
| |
Collapse
|