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Boma PM, Ngimbi SL, Kindundu JM, Wela JI, Ngoie NL, Ngwamah VM, Tshiswaka SM, Monga JK, Panda JM, Bonnechère B. Unveiling mortality risk factors in paediatric sickle cell disease patients during acute crises in the Democratic Republic of the Congo. Blood Cells Mol Dis 2024; 105:102828. [PMID: 38266515 DOI: 10.1016/j.bcmd.2024.102828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Revised: 01/11/2024] [Accepted: 01/17/2024] [Indexed: 01/26/2024]
Abstract
Sickle cell disease (SCD) is a significant health burden in the Democratic Republic of the Congo (DRC). This study aims to identify predictive factors of mortality in SCD children admitted to emergency care in Lubumbashi, DRC. We performed a non-interventional cohort follow-up on SCD patients aged 0 to 16 admitted for a "true emergency". Demographic, clinical, and biological data were collected. Univariate and multivariate logistic regression analyses were performed to identify significant risk factors associated with mortality. Among the 121 patients included, 24 died during the follow-up period. Univariate regression revealed age, Mikobi score, referral origin, stroke, and severe infection as significant risk factors. Multivariate analyses identified Hb, WBC, SR, and LDH as predictive factors of mortality. Notably, patients aged 12 to 16 years faced a higher risk, shifting the age of mortality from early to late childhood and adolescence. This study provides valuable insights into mortality risk factors for paediatric SCD patients during acute crises. Early diagnosis, regular follow-up, and therapeutic education are essential to improve patient outcomes and survival rates. These findings contribute to better disease management and targeted interventions, aiming to reduce mortality associated with SCD.
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Affiliation(s)
- Paul Muteb Boma
- Reference Centre for Sickle Cell Disease of Lubumbashi, Research Institute in Health Sciences, Lubumbashi, Democratic Republic of the Congo
| | | | - Junior Makiese Kindundu
- Reference Centre for Sickle Cell Disease of Lubumbashi, Research Institute in Health Sciences, Lubumbashi, Democratic Republic of the Congo
| | - Jean Israël Wela
- National Institute of Statistics, Kinshasa, Democratic Republic of the Congo
| | - Nathalie Lukanke Ngoie
- Provincial General Reference Hospital Jason Sendwe, Lubumbashi, Democratic Republic of the Congo
| | - Valentin Mukeba Ngwamah
- Reference Centre for Sickle Cell Disease of Lubumbashi, Research Institute in Health Sciences, Lubumbashi, Democratic Republic of the Congo
| | - Sandra Mbuyi Tshiswaka
- Provincial General Reference Hospital Jason Sendwe, Lubumbashi, Democratic Republic of the Congo
| | - Joséphine Kalenga Monga
- Provincial General Reference Hospital Jason Sendwe, Lubumbashi, Democratic Republic of the Congo; Department of Pediatrics, Faculty of Medicine, University of Lubumbashi, Lubumbashi, Democratic Republic of the Congo
| | - Jules Mulefu Panda
- Reference Centre for Sickle Cell Disease of Lubumbashi, Research Institute in Health Sciences, Lubumbashi, Democratic Republic of the Congo; Department of Surgery, Faculty of Medicine, University of Lubumbashi, Lubumbashi, Democratic Republic of the Congo
| | - Bruno Bonnechère
- REVAL Rehabilitation Research Center, Faculty of Rehabilitation Sciences, University of Hasselt, Diepenbeek, Belgium; Data Science Institute, University of Hasselt, Diepenbeek, Belgium.
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Ranque B, Diaw M, Dembele AK, Lapoumeroulie C, Offredo L, Tessougue O, Gueye SM, Diallo D, Diop S, Colin-Aronovicz Y, Jouven X, Blanc-Brude O, Tharaux PL, Le Jeune S, Connes P, Romana M, Le Van Kim C. Association of haemolysis markers, blood viscosity and microcirculation function with organ damage in sickle cell disease in sub-Saharan Africa (the BIOCADRE study). Br J Haematol 2023; 203:319-326. [PMID: 37583261 DOI: 10.1111/bjh.19006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2023] [Revised: 06/27/2023] [Accepted: 07/18/2023] [Indexed: 08/17/2023]
Abstract
Sickle cell anaemia (SCA) is a monogenic disease with a highly variable clinical course. We aimed to investigate associations between microvascular function, haemolysis markers, blood viscosity and various types of SCA-related organ damage in a multicentric sub-Saharan African cohort of patients with SCA. In a cross-sectional study, we selected seven groups of adult patients with SS phenotype in Dakar and Bamako based on the following complications: leg ulcer, priapism, osteonecrosis, retinopathy, high tricuspid regurgitant jet velocity (TRV), macro-albuminuria or none. Clinical assessment, echocardiography, peripheral arterial tonometry, laboratory tests and blood viscosity measurement were performed. We explored statistical associations between the biological parameters and the six studied complications. Among 235 patients, 58 had high TRV, 46 osteonecrosis, 43 priapism, 33 leg ulcers, 31 retinopathy and 22 macroalbuminuria, whereas 36 had none of these complications. Multiple correspondence analysis revealed no cluster of complications. Lactate dehydrogenase levels were associated with high TRV, and blood viscosity was associated with retinopathy and the absence of macroalbuminuria. Despite extensive phenotyping of patients, no specific pattern of SCA-related complications was identified. New biomarkers are needed to predict SCA clinical expression to adapt patient management, especially in Africa, where healthcare resources are scarce.
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Affiliation(s)
- Brigitte Ranque
- Université Paris Cité, Inserm, UMR S970, PARCC, Paris, France
- Service de Médecine Interne, Hôpital Européen Georges Pompidou, Assistance Publique des Hôpitaux de Paris, Paris, France
- LABEX GREX, Université Paris Cité, Paris, France
| | - Mor Diaw
- Laboratoire de Physiologie et Explorations Fonctionnelles, Faculté de Médecine, Pharmacie et Odontologie Université Cheikh Anta Diop de Dakar, Dakar, Senegal
- Unité Mixte Internationale (UMI 3189), "Environnement, Santé, Sociétés" CNRS, UCAD, CNRST, USTTB, UGB, Dakar, Senegal
| | | | | | - Lucile Offredo
- Université Paris Cité, Inserm, UMR S970, PARCC, Paris, France
| | - Oumar Tessougue
- Centre de Recherche et de Lutte Contre la Drépanocytose (CRLD), Bamako, Mali
| | | | - Dapa Diallo
- Centre de Recherche et de Lutte Contre la Drépanocytose (CRLD), Bamako, Mali
| | - Saliou Diop
- Centre National de Transfusion Sanguine (CNTS), Dakar, Senegal
| | - Yves Colin-Aronovicz
- LABEX GREX, Université Paris Cité, Paris, France
- Université Paris Cité and Université des Antilles, Inserm, BIGR, Paris, France
| | - Xavier Jouven
- Université Paris Cité, Inserm, UMR S970, PARCC, Paris, France
- LABEX GREX, Université Paris Cité, Paris, France
| | - Olivier Blanc-Brude
- Université Paris Cité, Inserm, UMR S970, PARCC, Paris, France
- LABEX GREX, Université Paris Cité, Paris, France
| | - Pierre-Louis Tharaux
- Université Paris Cité, Inserm, UMR S970, PARCC, Paris, France
- LABEX GREX, Université Paris Cité, Paris, France
| | - Sylvain Le Jeune
- Université Paris Cité, Inserm, UMR S970, PARCC, Paris, France
- Service de Médecine Interne, Hôpital Avicenne, Bobigny, Assistance-Publique Hôpitaux de Paris, Paris, France
| | - Philippe Connes
- LABEX GREX, Université Paris Cité, Paris, France
- Université Lyon 1, Laboratoire LIBM EA7424, Equipe «Biologie Vasculaire et du Globule Rouge», COMUE, Lyon, France
| | - Marc Romana
- LABEX GREX, Université Paris Cité, Paris, France
- Université Paris Cité and Université des Antilles, Inserm, BIGR, Paris, France
| | - Caroline Le Van Kim
- LABEX GREX, Université Paris Cité, Paris, France
- Université Paris Cité and Université des Antilles, Inserm, BIGR, Paris, France
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