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Obeagu EI, Obeagu GU. Malnutrition in sickle cell anemia: Prevalence, impact, and interventions: A Review. Medicine (Baltimore) 2024; 103:e38164. [PMID: 38758879 PMCID: PMC11098235 DOI: 10.1097/md.0000000000038164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/25/2023] [Accepted: 04/17/2024] [Indexed: 05/19/2024] Open
Abstract
Sickle Cell Anemia (SCA) is a hereditary hemoglobinopathy characterized by chronic hemolytic anemia, vaso-occlusive events, and a wide range of clinical complications. Malnutrition, often an underexplored aspect of this complex condition, plays a critical role in disease management and overall patient well-being. This publication provides a comprehensive review of the prevalence, impact, and interventions related to malnutrition in individuals with SCA. A thorough literature review reveals the multifaceted challenges faced by SCA patients in maintaining adequate nutrition. The pathophysiology of SCA, involving chronic inflammation, oxidative stress, and hypermetabolism, contributes to increased nutritional requirements and altered dietary patterns. Factors such as reduced appetite, nutrient malabsorption, dietary restrictions, and socioeconomic disparities further exacerbate the risk of malnutrition. Malnutrition is a prevalent issue among individuals with SCA, affecting patients of different age groups and disease severities. Nutritional deficiencies, including vitamins, minerals, and essential nutrients, are common in this population. The impact of malnutrition on disease outcomes is significant, with associations between nutrient status and complications such as pain crises, infections, and impaired quality of life. This paper also reviews nutritional interventions aimed at addressing malnutrition in SCA patients. While dietary counseling, supplementation, and personalized nutrition plans have shown promise in improving nutritional status, challenges such as patient adherence and access to healthcare must be addressed to optimize their effectiveness.
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Moura Neto JP, Albuquerque CCMX, Yahouedehou SCMA, Francisco MVL, Fraiji NA, de Siqueira IC, Gonçalves MS. Prevalence of arboviruses in sickle cell disease patients from two different regions of Brazil, the North and Northeast. Braz J Infect Dis 2024; 28:103741. [PMID: 38670165 PMCID: PMC11070587 DOI: 10.1016/j.bjid.2024.103741] [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: 11/29/2023] [Revised: 02/29/2024] [Accepted: 04/14/2024] [Indexed: 04/28/2024] Open
Abstract
Sickle Cell Disease (SCD) is a hereditary disease characterized by extravascular and intravascular hemolysis and clinical variability, from mild pain to potentially life-threatening. Arboviruses include mainly Zika (ZIKV), Chikungunya (CHKV), and Dengue (DENV) virus, and are considered a public and social health problem. The present cross-sectional observational study aimed to investigate the prevalence of arbovirus infection in SCD patients from two Brazilian cities, Salvador and Manaus located in Bahia and Amazonas states respectively. A total of 409 individuals with SCD were included in the study, and 307 (75.06 %) patients tested positive for DENV-IgG, 161 (39.36 %) for ZIKV-IgG, and 60 (14.67 %) for CHIKV-IgG. Only one individual was positive for DENV-NS1 and another for DENV-IgM, both from Salvador. No individuals had positive serology for ZIKV-IgM or CHIKV-IgM. Arbovirus positivity by IgG testing revealed that the SCD group presented high frequencies in both cities. Interestingly, these differences were only statistically significant for ZIKV-IgG (p = 0.023) and CHIKV-IgG (p = 0.005) among SCD patients from Manaus. The reshaping of arbovirus from its natural habitat by humans due to disorderly urban expansion and the ease of international Mobility has been responsible for facilitating the spread of vector-borne infectious diseases in humans. We found the need for further studies on arboviruses in this population to elucidate the real association and impact, especially in acute infection. We hope that this study will contribute to improvements in the personalized clinical follow-up of SCD patients, identifying the influence of arbovirus infection in severe disease manifestations.
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Affiliation(s)
- José Pereira Moura Neto
- Fundação Oswaldo Cruz (FIOCRUZ), Instituto Gonçalo Moniz, Salvador, BA, Brazil; Faculdade de Ciências Farmacêuticas, Laboratório de Análise Especializada em Biologia Molecular (LAEBM), Universidade Federal do Amazonas, Manaus, AM, Brazil; Fundação Hospitalar de Hematologia e Hemoterapia do Amazonas (HEMOAM), Universidade do Estado do Amazonas (UEA), Manaus, AM, Brazil.
| | | | | | | | - Nelson Abrahim Fraiji
- Fundação Hospitalar de Hematologia e Hemoterapia do Amazonas (HEMOAM), Universidade do Estado do Amazonas (UEA), Manaus, AM, Brazil
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Peprah E, Gyamfi J, Lee JT, Islam F, Opeyemi J, Tampubolon S, Ojo T, Qiao W, Mai A, Wang C, Vieira D, Meda S, Adenikinju D, Osei-Tutu N, Ryan N, Ogedegbe G. Analysis of the 2007-2018 National Health Interview Survey (NHIS): Examining Neurological Complications among Children with Sickle Cell Disease in the United States. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6137. [PMID: 37372724 PMCID: PMC10298081 DOI: 10.3390/ijerph20126137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 05/24/2023] [Accepted: 06/12/2023] [Indexed: 06/29/2023]
Abstract
This study compared neurological complications among a national sample of United States children with or without sickle cell disease (SCD) and evaluated health status, healthcare and special education utilization patterns, barriers to care, and association of SCD status and demographics/socioeconomic status (SES) on comorbidities and healthcare utilization. Data was acquired from the National Health Interview Survey (NHIS) Sample Child Core questionnaire 2007-2018 dataset that included 133,542 children. An affirmation from the guardian of the child determined the presence of SCD. Regression analysis was used to compare the associations between SCD and demographics/SES on neurological conditions at p < 0.05. Furthermore, adjusted odds ratios (AORs) were estimated for having various neurological conditions. Of the 133,481 children included in the NHIS, the mean age was 8.5 years (SD: 0.02) and 215 had SCD. Of the children with SCD, the sample composition included male (n = 110), and Black (n = 82%). The SCD sample had higher odds of having neuro-developmental conditions (p < 0.1). Families of Black children (55% weighted) reported household incomes < 100% of federal poverty level. Black children were more likely to experience longer wait times to see the doctor (AOR, 0.3; CI 0.1-1.1). Compared to children without SCD, those with SCD had a greater chance of seeing a medical specialist within 12 months (AOR 2.3; CI 1.5-3.7). This representative sample of US children with SCD shows higher odds of developing neurological complications, increased healthcare and special education services utilization, with Black children experiencing a disproportionate burden. This creates the urgency to address the health burden for children with SCD by implementing interventions in healthcare and increasing education assistance programs to combat neurocognitive impairments, especially among Black children.
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Affiliation(s)
- Emmanuel Peprah
- Global Health Program, Department of Social and Behavioral Sciences, ISEE Lab, NYU School of Global Public Health, 708 Broadway, 4th FL, New York, NY 10003, USA; (J.G.); (J.T.L.); (F.I.); (J.O.); (S.T.); (T.O.); (D.V.); (S.M.); (D.A.); (N.O.-T.); (N.R.)
| | - Joyce Gyamfi
- Global Health Program, Department of Social and Behavioral Sciences, ISEE Lab, NYU School of Global Public Health, 708 Broadway, 4th FL, New York, NY 10003, USA; (J.G.); (J.T.L.); (F.I.); (J.O.); (S.T.); (T.O.); (D.V.); (S.M.); (D.A.); (N.O.-T.); (N.R.)
| | - Justin Tyler Lee
- Global Health Program, Department of Social and Behavioral Sciences, ISEE Lab, NYU School of Global Public Health, 708 Broadway, 4th FL, New York, NY 10003, USA; (J.G.); (J.T.L.); (F.I.); (J.O.); (S.T.); (T.O.); (D.V.); (S.M.); (D.A.); (N.O.-T.); (N.R.)
| | - Farha Islam
- Global Health Program, Department of Social and Behavioral Sciences, ISEE Lab, NYU School of Global Public Health, 708 Broadway, 4th FL, New York, NY 10003, USA; (J.G.); (J.T.L.); (F.I.); (J.O.); (S.T.); (T.O.); (D.V.); (S.M.); (D.A.); (N.O.-T.); (N.R.)
| | - Jumoke Opeyemi
- Global Health Program, Department of Social and Behavioral Sciences, ISEE Lab, NYU School of Global Public Health, 708 Broadway, 4th FL, New York, NY 10003, USA; (J.G.); (J.T.L.); (F.I.); (J.O.); (S.T.); (T.O.); (D.V.); (S.M.); (D.A.); (N.O.-T.); (N.R.)
| | - Siphra Tampubolon
- Global Health Program, Department of Social and Behavioral Sciences, ISEE Lab, NYU School of Global Public Health, 708 Broadway, 4th FL, New York, NY 10003, USA; (J.G.); (J.T.L.); (F.I.); (J.O.); (S.T.); (T.O.); (D.V.); (S.M.); (D.A.); (N.O.-T.); (N.R.)
| | - Temitope Ojo
- Global Health Program, Department of Social and Behavioral Sciences, ISEE Lab, NYU School of Global Public Health, 708 Broadway, 4th FL, New York, NY 10003, USA; (J.G.); (J.T.L.); (F.I.); (J.O.); (S.T.); (T.O.); (D.V.); (S.M.); (D.A.); (N.O.-T.); (N.R.)
| | - Wanqiu Qiao
- Department of Biostatistics, NYU School of Global Public Health, 708 Broadway, New York, NY 10003, USA; (W.Q.); (A.M.); (C.W.)
| | - Andi Mai
- Department of Biostatistics, NYU School of Global Public Health, 708 Broadway, New York, NY 10003, USA; (W.Q.); (A.M.); (C.W.)
| | - Cong Wang
- Department of Biostatistics, NYU School of Global Public Health, 708 Broadway, New York, NY 10003, USA; (W.Q.); (A.M.); (C.W.)
| | - Dorice Vieira
- Global Health Program, Department of Social and Behavioral Sciences, ISEE Lab, NYU School of Global Public Health, 708 Broadway, 4th FL, New York, NY 10003, USA; (J.G.); (J.T.L.); (F.I.); (J.O.); (S.T.); (T.O.); (D.V.); (S.M.); (D.A.); (N.O.-T.); (N.R.)
- NYU Health Sciences Library, 577 First Avenue, New York, NY 10016, USA
| | - Shreya Meda
- Global Health Program, Department of Social and Behavioral Sciences, ISEE Lab, NYU School of Global Public Health, 708 Broadway, 4th FL, New York, NY 10003, USA; (J.G.); (J.T.L.); (F.I.); (J.O.); (S.T.); (T.O.); (D.V.); (S.M.); (D.A.); (N.O.-T.); (N.R.)
| | - Deborah Adenikinju
- Global Health Program, Department of Social and Behavioral Sciences, ISEE Lab, NYU School of Global Public Health, 708 Broadway, 4th FL, New York, NY 10003, USA; (J.G.); (J.T.L.); (F.I.); (J.O.); (S.T.); (T.O.); (D.V.); (S.M.); (D.A.); (N.O.-T.); (N.R.)
| | - Nana Osei-Tutu
- Global Health Program, Department of Social and Behavioral Sciences, ISEE Lab, NYU School of Global Public Health, 708 Broadway, 4th FL, New York, NY 10003, USA; (J.G.); (J.T.L.); (F.I.); (J.O.); (S.T.); (T.O.); (D.V.); (S.M.); (D.A.); (N.O.-T.); (N.R.)
| | - Nessa Ryan
- Global Health Program, Department of Social and Behavioral Sciences, ISEE Lab, NYU School of Global Public Health, 708 Broadway, 4th FL, New York, NY 10003, USA; (J.G.); (J.T.L.); (F.I.); (J.O.); (S.T.); (T.O.); (D.V.); (S.M.); (D.A.); (N.O.-T.); (N.R.)
| | - Gbenga Ogedegbe
- Institute for Excellence in Health Equity, NYU Langone Health, 180 Madison Avenue, New York, NY 10016, USA;
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Antonelli Rossi DA, De Araujo Junior JA, Luvizutto GJ, Bazan R, Salmazo PS, Modolo GP, Hueb JC, Nunes HRDC, Hokama NK, Minicucci MF, Roscani MG, Zanati Bazan SG. Effect of a Physical Exercise Program on the Inflammatory Response, Cardiac Functions, Functional Capacity, and Quality of Life in Patients with Sickle Cell Disease. J Clin Med 2023; 12:3952. [PMID: 37373647 PMCID: PMC10299033 DOI: 10.3390/jcm12123952] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 05/13/2023] [Accepted: 06/03/2023] [Indexed: 06/29/2023] Open
Abstract
INTRODUCTION The beneficial effects of physical exercise on functional capacity and inflammatory response are well-known in cardiovascular diseases; however, studies on sickle cell disease (SCD) are limited. It was hypothesized that physical exercise may exert a favorable effect on the inflammatory response of SCD patients, contributing to an improved quality of life. This study aimed to evaluate the effect of a regular physical exercise program on the anti-inflammatory responses in SCD patients. METHODS A non-randomized clinical trial was conducted in adult SCD patients. The patients were divided into two groups: 1-Exercise Group, which received a physical exercise program three times a week for 8 weeks, and; 2-Control Group, with routine physical activities. All patients underwent the following procedures initially and after eight weeks of protocol: clinical evaluation, physical evaluation, laboratory evaluation, quality of life evaluation, and echocardiographic evaluation. STATISTICAL ANALYSIS Comparisons between groups were made using Student's t-test, Mann-Whitney test, chi-square test, or Fisher's exact test. Spearman's correlation coefficient was calculated. The significance level was set at p < 0.05. RESULTS There was no significant difference in inflammatory response between the Control and Exercise Groups. The Exercise Group showed an improvement in peak VO2 values (p < 0.001), an increase in the distance walked (p < 0.001), an improvement in the limitation domain due to the physical aspects of the 36-Item Short Form Health Survey (SF-36) quality of life questionnaire (p = 0.022), and an increase in physical activity related to leisure (p < 0.001) and walking (p = 0.024) in the International Physical Activity Questionnaire (IPAQ). There was a negative correlation between IL-6 values and distance walked on the treadmill (correlation coefficient -0.444, p = 0.020) and the estimated peak VO2 values (correlation coefficient -0.480; p = 0.013) in SCD patients in both groups. CONCLUSIONS The aerobic exercise program did not change the inflammatory response profile of SCD patients, nor did it show unfavorable effects on the parameters evaluated, and patients with lower functional capacity were those with the highest levels of IL-6.
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Affiliation(s)
- Daniele Andreza Antonelli Rossi
- Department of Internal Medicine, Botucatu Medical School-UNESP, São Paulo State University, Botucatu 18618-687, Brazil; (D.A.A.R.); (J.A.D.A.J.); (J.C.H.); (N.K.H.); (M.F.M.)
| | - Jonas Alves De Araujo Junior
- Department of Internal Medicine, Botucatu Medical School-UNESP, São Paulo State University, Botucatu 18618-687, Brazil; (D.A.A.R.); (J.A.D.A.J.); (J.C.H.); (N.K.H.); (M.F.M.)
| | - Gustavo José Luvizutto
- Department of Applied Physical Therapy, Federal University of Triângulo Mineiro, Uberaba 38065-430, Brazil;
| | - Rodrigo Bazan
- Department of Neurology, Botucatu Medical School-UNESP, São Paulo State University, Botucatu 18618-970, Brazil; (R.B.); (G.P.M.)
| | - Péricles Sidnei Salmazo
- Department of Medicine, Faculty of Medical and Health Sciences, Pontifical Catholic University of São Paulo, Sorocaba 18052-490, Brazil;
| | - Gabriel Pinheiro Modolo
- Department of Neurology, Botucatu Medical School-UNESP, São Paulo State University, Botucatu 18618-970, Brazil; (R.B.); (G.P.M.)
| | - João Carlos Hueb
- Department of Internal Medicine, Botucatu Medical School-UNESP, São Paulo State University, Botucatu 18618-687, Brazil; (D.A.A.R.); (J.A.D.A.J.); (J.C.H.); (N.K.H.); (M.F.M.)
| | | | - Newton Key Hokama
- Department of Internal Medicine, Botucatu Medical School-UNESP, São Paulo State University, Botucatu 18618-687, Brazil; (D.A.A.R.); (J.A.D.A.J.); (J.C.H.); (N.K.H.); (M.F.M.)
| | - Marcos Ferreira Minicucci
- Department of Internal Medicine, Botucatu Medical School-UNESP, São Paulo State University, Botucatu 18618-687, Brazil; (D.A.A.R.); (J.A.D.A.J.); (J.C.H.); (N.K.H.); (M.F.M.)
| | - Meliza Goi Roscani
- Department of Medicine, Federal University of Sao Carlos-UFSCar, São Carlos 13565-251, Brazil;
| | - Silméia Garcia Zanati Bazan
- Department of Internal Medicine, Botucatu Medical School-UNESP, São Paulo State University, Botucatu 18618-687, Brazil; (D.A.A.R.); (J.A.D.A.J.); (J.C.H.); (N.K.H.); (M.F.M.)
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Ally SA, Han J, Sun R, Molokie RE, Gordeuk VR, Lash JP, Saraf SL. Community-level socioeconomic distress is associated with nutritional status in adults with sickle cell anemia. EJHAEM 2023; 4:432-436. [PMID: 37206276 PMCID: PMC10188476 DOI: 10.1002/jha2.661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 01/30/2023] [Accepted: 02/03/2023] [Indexed: 05/21/2023]
Abstract
Sickle cell anemia (SCA) negatively impacts the ability to achieve educational and occupational goals increasing vulnerability to socioeconomic challenges. In a cross-sectional analysis of 332 SCA adults, we investigated whether the distressed community index (DCI) was associated with SCA-related complications and nutritional status. More patients with higher DCI had Medicaid insurance. A higher DCI was independently associated with tobacco use and lower body mass index, serum albumin, and vitamin D 25-OH levels after adjusting for insurance status but was not associated with SCA-related complications. Future studies investigating access to healthy foods may help improve health equity in patients with SCA.
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Affiliation(s)
- Syeda Akila Ally
- Division of Hematology and OncologyDepartment of MedicineUniversity of Illinois at ChicagoChicagoIllinoisUSA
| | - Jin Han
- Division of Hematology and OncologyDepartment of MedicineUniversity of Illinois at ChicagoChicagoIllinoisUSA
- Department of Pharmacy PracticeCollege of PharmacyUniversity of Illinois at ChicagoChicagoIllinoisUSA
| | - Ryan Sun
- Division of Hematology and OncologyDepartment of MedicineUniversity of Illinois at ChicagoChicagoIllinoisUSA
| | - Robert E. Molokie
- Division of Hematology and OncologyDepartment of MedicineUniversity of Illinois at ChicagoChicagoIllinoisUSA
- Department of MedicineJesse Brown VA Medical CenterChicagoIllinoisUSA
| | - Victor R. Gordeuk
- Division of Hematology and OncologyDepartment of MedicineUniversity of Illinois at ChicagoChicagoIllinoisUSA
| | - James P. Lash
- Division of NephrologyDepartment of MedicineUniversity of Illinois at ChicagoChicagoIllinoisUSA
| | - Santosh L. Saraf
- Division of Hematology and OncologyDepartment of MedicineUniversity of Illinois at ChicagoChicagoIllinoisUSA
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Abijay CA, Kemper WC, Pham A, Johnson RF, Mitchell RB. Pediatric Obstructive Sleep Apnea and Sickle Cell Disease: Demographic and Polysomnographic Features. Laryngoscope 2023. [PMID: 36883666 DOI: 10.1002/lary.30638] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 01/29/2023] [Accepted: 02/22/2023] [Indexed: 03/09/2023]
Abstract
OBJECTIVE Obstructive sleep apnea (OSA) is prevalent in children with sickle cell disease (SCD). We compared the demographic, clinical, and polysomnographic characteristics of children with and without SCD. METHODS This retrospective chart review included children with SCD (n = 89) and without SCD (n = 192) ages 1-18 years referred for polysomnography (PSG) for OSA. RESULTS Children with SCD were predominantly African American when compared to the non-SCD group (95% vs. 28%, p < 0.001). The non-SCD group had a higher BMI z-score (1.3 vs. 0.1, p < 0.001) and a higher percentage of patients classified as obese (52% vs. 13%, p < 0.001). In children with SCD, 43% had severe OSA and 5.6% had no OSA. In the non-SCD group, 67% had severe OSA and 4.7% had no OSA. The SCD compared to the non-SCD group had a lower mean apnea-hypopnea index (AHI) (13.6 vs. 22.4, p = 0.006) but a higher percent sleep time below 90% oxygen saturation (10.5% vs. 3.5%, p < 0.001). Predicted probability for severe OSA in children with SCD decreased with increasing age (OR = 0.81, 95% CI: 0.70-0.93). CONCLUSION Children with SCD referred for PSG are at risk for severe OSA. Compared with the non-SCD group, most children were African American with lower rates of obesity and lower AHIs but longer periods of nocturnal hypoxemia. Likelihood for severe OSA decreased with increasing age for the SCD group. LEVEL OF EVIDENCE Level III, retrospective comparative study Laryngoscope, 2023.
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Affiliation(s)
| | | | - An Pham
- Children's Medical Center Dallas, Dallas, Texas, USA.,University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Romaine F Johnson
- Children's Medical Center Dallas, Dallas, Texas, USA.,University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Ron B Mitchell
- Children's Medical Center Dallas, Dallas, Texas, USA.,University of Texas Southwestern Medical Center, Dallas, Texas, USA
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Gyamfi J, Tampubolon S, Lee JT, Islam F, Ojo T, Opeyemi J, Qiao W, Mai A, Wang C, Vieira D, Ryan N, Osei-Tutu NH, Adenikinju D, Meda S, Ogedegbe G, Peprah E. Characterisation of medical conditions of children with sickle cell disease in the USA: findings from the 2007-2018 National Health Interview Survey (NHIS). BMJ Open 2023; 13:e069075. [PMID: 36854589 PMCID: PMC9980332 DOI: 10.1136/bmjopen-2022-069075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 02/15/2023] [Indexed: 03/02/2023] Open
Abstract
OBJECTIVES We used the National Health Interview Survey (NHIS) data set to examine the prevalence of comorbid medical conditions; explore barriers to accessing healthcare and special educational services; and assess the associations between sickle cell disease (SCD) status and demographics/socioeconomic status (SES), and social determinants of health (SDoH) on comorbidities among children in the USA. DESIGN Cross-sectional. SETTING NHIS Sample Child Core questionnaire 2007-2018 data set. PARTICIPANTS 133 481 children; presence of SCD was determined by an affirmative response from the adult or guardian of the child. MAIN OUTCOME MEASURES Multivariate logistic regression was used to compare the associations between SCD status, SES and SDoH for various medical conditions for all races and separately for black children at p<0.05. RESULTS 133 481 children (mean age 8.5 years, SD: 0.02), 215 had SCD and ~82% (weighted) of the children with SCD are black. Children with SCD were more likely to suffer from comorbid conditions, that is, anaemia (adjusted OR: 27.1, p<0.001). Furthermore, children with SCD had at least two or more emergency room (ER) visits (p<0.001) and were more likely to have seen a doctor 1-15 times per year (p<0.05) compared with children without SCD. Household income (p<0.001) and maternal education were lower for children with SCD compared with children without SCD (52.4% vs 63.5% (p<0.05)). SCD children with a maternal parent who has < / > High School degree were less likely to have no ER visits or 4-5 ER visits, and more likely to have 2-3 ER visits within 12 months. CONCLUSION Children with SCD experienced significant comorbid conditions and have high healthcare usage, with black children being disproportionately affected. Moreover, maternal education status and poverty level illustrates how impactful SES can be on healthcare seeking behaviour for the SCD population. SDoH have significant implications for managing paediatric patients with SCD in clinical settings.
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Affiliation(s)
- Joyce Gyamfi
- School of Global Public Health, Department of Social and Behavioral Sciences, ISEE Lab, New York University, New York, New York, USA
| | - Siphra Tampubolon
- School of Global Public Health, Department of Social and Behavioral Sciences, ISEE Lab, New York University, New York, New York, USA
| | - Justin Tyler Lee
- School of Global Public Health, Department of Social and Behavioral Sciences, ISEE Lab, New York University, New York, New York, USA
| | - Farha Islam
- School of Global Public Health, Department of Social and Behavioral Sciences, ISEE Lab, New York University, New York, New York, USA
| | - Temitope Ojo
- School of Global Public Health, Department of Social and Behavioral Sciences, ISEE Lab, New York University, New York, New York, USA
| | - Jumoke Opeyemi
- School of Global Public Health, Department of Social and Behavioral Sciences, ISEE Lab, New York University, New York, New York, USA
| | - Wanqiu Qiao
- Department of Biostatistics, New York University, New York, New York, USA
| | - Andi Mai
- Department of Biostatistics, New York University, New York, New York, USA
| | - Cong Wang
- Department of Biostatistics, New York University, New York, New York, USA
| | - Dorice Vieira
- School of Global Public Health, Department of Social and Behavioral Sciences, ISEE Lab, New York University, New York, New York, USA
- Medical Library Services, New York University School of Medicine, New York, New York, USA
| | - Nessa Ryan
- School of Global Public Health, Department of Social and Behavioral Sciences, ISEE Lab, New York University, New York, New York, USA
| | - Nana H Osei-Tutu
- School of Global Public Health, Department of Social and Behavioral Sciences, ISEE Lab, New York University, New York, New York, USA
| | - Deborah Adenikinju
- School of Global Public Health, Department of Social and Behavioral Sciences, ISEE Lab, New York University, New York, New York, USA
| | - Shreya Meda
- School of Global Public Health, Department of Social and Behavioral Sciences, ISEE Lab, New York University, New York, New York, USA
| | - Gbenga Ogedegbe
- Institute for Excellence in Health Equity (IEHE), New York University Grossman School of Medicine, New York, New York, USA
| | - Emmanuel Peprah
- School of Global Public Health, Department of Social and Behavioral Sciences, ISEE Lab, New York University, New York, New York, USA
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Barriteau CM, Feinglass J, Kayle M, VonAchen P, Liem RI, Badawy SM, Kan K. Emergency department visits and hospitalizations among patients with sickle cell disease in illinois, 2016-2020. Pediatr Hematol Oncol 2023; 40:70-75. [PMID: 35612367 DOI: 10.1080/08880018.2022.2071511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Sickle cell disease (SCD) state level surveillance data are limited. We performed a retrospective review of emergency department (ED) visits and hospitalizations from individuals with SCD in Illinois (2016-2020) using the Illinois Health and Hospital Association's Comparative Health Care and Hospital Data Reporting Services. There were 48,094 outpatient ED visits and 31,686 hospitalizations. Most visits (67%) occurred in Cook County, were covered by public insurance (77%) and were from individuals with medium high (40.3%) or high (36.1%) poverty levels. SCD healthcare utilization remains high and surveillance data may inform SCD program development and resource allocation at the state level.AbbreviationsCDCCenters for Disease Control and PreventionEDEmergency DepartmentFDAFood & Drug AdministrationICDInternational Classification of DiseasesILIllinoisSCDSickle cell disease.
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Affiliation(s)
- Christina M Barriteau
- Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.,Division of Hematology, Oncology and Stem Cell Transplant, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
| | - Joe Feinglass
- Department of General Internal Medicine and Geriatrics, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Mariam Kayle
- Clinical Health Systems and Analytics Division, Duke University School of Nursing, Durham, NC, USA
| | - Paige VonAchen
- Department of Medicine, Boston Children's Hospital, Boston, MA, USA
| | - Robert I Liem
- Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.,Division of Hematology, Oncology and Stem Cell Transplant, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
| | - Sherif M Badawy
- Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.,Division of Hematology, Oncology and Stem Cell Transplant, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
| | - Kristin Kan
- Department of Pediatrics, Division of Academic General Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago and Northwestern, University Feinberg School of Medicine, Chicago, IL, USA.,Mary Ann & J. Milburn Smith Child Health Research, Outreach, and Advocacy Center, Stanley Manne Children's Research Institute, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
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9
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Moukalled NM, Bou Fakhredin R, Taher AT. Pregnancy and sickle cell disease: an overview of complications and suggested perinatal care. Expert Rev Hematol 2022; 15:1055-1061. [PMID: 36413684 DOI: 10.1080/17474086.2022.2151432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Pregnancy in women with sickle cell disease (SCD) has been identified as high risk owing to increased incidence of materno-fetal complications across various studies and reports. These complications include consequences related to the underlying hemoglobinopathy; chronic anemia/associated inflammation, and pregnancy related including the risk for thromboembolism, bleeding and maternal mortality. Outcomes of neonates born to women with SCD has been suboptimal over the years with recent improvement due to strict monitoring, preventive and therapeutic measures. Much is yet to be unraveled regarding the optimal management of women with SCD during pregnancy, identifying target hemoglobin, delivery mode or timing among others. AREAS COVERED This review includes a summary of available data of the maternal and fetal outcomes; in addition to current recommendations for monitoring and management of women with SCD during pregnancy. EXPERT OPINION To have a successful pregnancy, women should be closely monitored, and interventions provided as needed to guarantee adequate management of anemia, as well as prevention, diagnosis and management of disease. They should also be educated regarding their reproductive health, emphasizing that pregnancy is possible, and achieving optimal results depends on providing adequate care in a health care facility with expertise in high-risk pregnancies and SCD.
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Affiliation(s)
- Nour M Moukalled
- Division of Hematology and Oncology, Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Rayan Bou Fakhredin
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Ali T Taher
- Division of Hematology and Oncology, Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon
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10
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Penkert RR, Azul M, Sealy RE, Jones BG, Dowdy J, Hayden RT, Tang L, Ross AC, Hankins JS, Hurwitz JL. Hypothesis: Low Vitamin A and D Levels Worsen Clinical Outcomes When Children with Sickle Cell Disease Encounter Parvovirus B19. Nutrients 2022; 14:nu14163415. [PMID: 36014920 PMCID: PMC9414848 DOI: 10.3390/nu14163415] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 07/31/2022] [Accepted: 08/10/2022] [Indexed: 12/12/2022] Open
Abstract
Human parvovirus B19 causes life-threatening anemia due to transient red cell aplasia (TRCA) in individuals with sickle cell disease (SCD). Children with SCD experiencing profound anemia during TRCA often require red blood cell transfusions and hospitalization. The prevalence of vitamin deficiencies in SCD is high and deficiencies are associated with respiratory and pain symptoms, but the effects of vitamins on acute infection with parvovirus B19 remain unclear. We performed a clinical study in which 20 SCD patients hospitalized with parvovirus B19 infections (Day 0) were monitored over a 120-day time course to query relationships between vitamins A and D and clinical outcomes. There were significant negative correlations between Day 0 vitamin levels and disease consequences (e.g., red blood cell transfusion requirements, inflammatory cytokines). There were significant positive correlations (i) between Day 0 vitamins and peak virus-specific antibodies in nasal wash, and (ii) between Day 0 virus-specific serum plus nasal wash antibodies and absolute reticulocyte counts. There was a significant negative correlation between Day 0 virus-specific serum antibodies and virus loads. To explain the results, we propose circular and complex mechanisms. Low baseline vitamin levels may weaken virus-specific immune responses to permit virus amplification and reticulocyte loss; consequent damage may further reduce vitamin levels and virus-specific immunity. While the complex benefits of vitamins are not fully understood, we propose that maintenance of replete vitamin A and D levels in children with SCD will serve as prophylaxis against parvovirus B19-induced TRCA complications.
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Affiliation(s)
- Rhiannon R. Penkert
- Department of Infectious Diseases, St. Jude Children’s Research Hospital, 262 Danny Thomas Place, Memphis, TN 38105, USA
| | - Melissa Azul
- Department of Hematology, St. Jude Children’s Research Hospital, Memphis, TN 38105, USA
| | - Robert E. Sealy
- Department of Infectious Diseases, St. Jude Children’s Research Hospital, 262 Danny Thomas Place, Memphis, TN 38105, USA
| | - Bart G. Jones
- Department of Infectious Diseases, St. Jude Children’s Research Hospital, 262 Danny Thomas Place, Memphis, TN 38105, USA
| | - Jola Dowdy
- Department of Bone Marrow Transplant and Cellular Therapy, St. Jude Children’s Research Hospital, Memphis, TN 38105, USA
| | - Randall T. Hayden
- Department of Pathology, St. Jude Children’s Research Hospital, Memphis, TN 38105, USA
| | - Li Tang
- Department of Biostatistics, St. Jude Children’s Research Hospital, Memphis, TN 38105, USA
| | - A. Catharine Ross
- Department of Nutritional Sciences, Pennsylvania State University, University Park, PA 16802, USA
| | - Jane S. Hankins
- Department of Hematology, St. Jude Children’s Research Hospital, Memphis, TN 38105, USA
| | - Julia L. Hurwitz
- Department of Infectious Diseases, St. Jude Children’s Research Hospital, 262 Danny Thomas Place, Memphis, TN 38105, USA
- Department of Microbiology, Immunology and Biochemistry, University of Tennessee Health Science Center, Memphis, TN 38163, USA
- Correspondence:
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11
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Fernández CR, Licursi M, Wolf R, Lee MT, Green NS. Food insecurity, housing instability, and dietary quality among children with sickle cell disease: Assessment from a single urban center. Pediatr Blood Cancer 2022; 69:e29463. [PMID: 34811867 PMCID: PMC8957542 DOI: 10.1002/pbc.29463] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 10/04/2021] [Accepted: 10/25/2021] [Indexed: 11/07/2022]
Abstract
BACKGROUND Food insecurity and housing instability, both social determinants of health (SDoH), disproportionately affect economically unstable, under-resourced US communities in which children with sickle cell disease (SCD) live. Association between these SDoH markers and dietary quality among children with SCD is unknown. PROCEDURES We assessed a cross-sectional sample of dyadic parent-child patients and young adult patients up to age 21 from one pediatric SCD center. Food insecurity, housing instability, and dietary quality were measured using validated US instruments and a food frequency questionnaire. Better dietary quality was defined using US dietary guidelines. Multivariate regression assessed for associations among dietary quality and food insecurity with or without (±) housing instability and housing instability alone. RESULTS Of 100 enrolled participants, 53% were Black and 43% Hispanic; mean age 10.6 ± 5.6 years. Overall, 70% reported less than or equal to one economic instability: 40% housing instability alone and 30% both food insecurity and housing instability. Eighty percent received more than or equal to one federal food assistance benefit. Compared to no economic instability, food insecurity ± housing instability was significantly associated with higher intake of higher dairy and pizza, while housing instability alone was significantly associated with higher dairy intake. Food insecurity ± housing instability was significantly associated with lower intake of whole grains compared to housing instability alone. CONCLUSIONS Our sample reported high frequencies of both food insecurity and housing instability; having more than or equal to one SDoH was associated with elements of poorer diet quality. Screening families of children with SCD for food insecurity and housing instability may identify those with potential nutrition-related social needs.
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Affiliation(s)
| | - Maureen Licursi
- Morgan Stanley Children’s Hospital of NewYork-Presbyterian, New York, NY
| | - Randi Wolf
- Teachers College of Columbia University, New York, NY
| | - Margaret T. Lee
- Department of Pediatrics, Columbia University Irving Medical Center, New York, NY
| | - Nancy S. Green
- Department of Pediatrics, Columbia University Irving Medical Center, New York, NY
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12
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Yousif M, Abdelrahman A, Al Jamea LH, Al-Yami FS, Woodman A. Psychosocial Impact of Sickle Cell Disease and Diabetes Mellitus on Affected Children and Their Parents in Khartoum State, Sudan. J Trop Pediatr 2022; 68:6596143. [PMID: 35641127 DOI: 10.1093/tropej/fmac042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
This study aimed to assess the psychosocial impact of sickle cell disease (SCD) and diabetes mellitus on children and their parents in Sudan, and the relationship between socioeconomic status and psychosocial issues. A descriptive, cross-sectional study was conducted among n = 320 children aged 6-12 years, of whom n = 170 were diagnosed with SCD, n = 150 children with diabetes mellitus and their parents. The strengths and difficulties questionnaire (SDQ scale) was used to assess the psychosocial aspect of children. Depression, Anxiety, Stress Scale -21 Items (DASS 21) was used to assess the psychological well-being of the caregivers. Data on psychological problems of children with SCD showed that 66.5% had emotional symptoms, 18.2% had conduct problems and 19.4% hyperactivity. Data of parents showed that 45.9% of parents did not experience depression; 27.9% were moderately depressed group. Data on psychological problems among children with diabetes showed that 57.3% experienced emotional symptoms, conduct problems were close to the average among 66%. Data on psychological problems among parents of children with diabetes showed that 45.3% of parents did not experience depression; 22.7% belonged to the moderately depressed group. Psychosocial problems were common both among children and parents. More research is needed in the context of caring for a child with chronic diseases and the role of health care providers in adapting and mitigating psychological problems among both parents and children.
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Affiliation(s)
- Magda Yousif
- Nursing Department, Prince Sultan Military College of Health Sciences, Dhahran, Saudi Arabia
| | - Abdalla Abdelrahman
- Psychiatric Department, Faculty of Medicine, University of Khartoum, Khartoum, Sudan
| | - Lamiaa H Al Jamea
- Department of Clinical Laboratory Sciences, Prince Sultan Military College of Health Sciences, Dhahran, Saudi Arabia
| | - Fatimah S Al-Yami
- Department of Medical Laboratory, King Fahad Military Medical Complex, Dhahran, Saudi Arabia
| | - Alexander Woodman
- Vice Deanship of Postgraduate Studies and Research, Prince Sultan Military College of Health Sciences, Dhahran, Saudi Arabia
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13
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Gustin C, Pimentel W, Sarsur M, Dadalto L. A bioética da intervenção como possibilidade de inclusão social de pacientes com doença falciforme em tempos de COVID-19. REVISTA LATINOAMERICANA DE BIOÉTICA 2021. [DOI: 10.18359/rlbi.4703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Este artigo discute a exclusão social vivida pelos indivíduos brasileiros com a doença falciforme, sob a perspectiva da bioética de intervenção. Trata-se de uma enfermidade na qual o afetado herda de seus progenitores o gene responsável pelo formato diferenciado da hemoglobina; ademais, apresenta maior incidência na população negra, uma vez que a alteração do formato da hemoglobina foi resultado da evolução do próprio corpo para evitar a contração da malária no continente africano. Além da exclusão social que a população negra sofre, há, ainda, um maior grau de preconceito advindo dos efeitos da doença. Revela-se que as dificuldades enfrentadas pelos acometidos são agravadas em decorrência da COVID-19. Portanto, a criação de políticas públicas que se alicercem nos parâmetros da bioética da intervenção, cujo foco principal é a vulnerabilidade e os desafios persistentes da sociedade, é proposta como possível ação para minorar as consequências da doença falciforme na população por ela afetada.
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14
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Gerardin M, Rousselet M, Couec ML, Masseau A, Guerlais M, Authier N, Deheul S, Roussin A, Micallef J, Djezzar S, Feuillet F, Jolliet P, Victorri-Vigneau C. Descriptive analysis of sickle cell patients living in France: The PHEDRE cross-sectional study. PLoS One 2021; 16:e0248649. [PMID: 33735176 PMCID: PMC7971579 DOI: 10.1371/journal.pone.0248649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Accepted: 03/02/2021] [Indexed: 11/18/2022] Open
Abstract
Background Sickle cell disease (SCD) induces chronic haemolytic anaemia and intermittent vaso-occlusion that results in tissue ischaemia causing acute, severe pain episodes that can lead to frequent hospitalizations. These consequences can have repercussions on family, social, school and/or professional life. Here, we present some of the results of the PHEDRE study (Pharmacodépendance Et DREpanocytose—drug dependence and sickle-cell disease), which is the largest study of patients with SCD in France. This paper intends to describe characteristics of the French SCD population. We also aimed to assess the impact of the disease on the lives of patients using objective and subjective variables. Methods The PHEDRE study was a national multicentric observational study. Adults, adolescents and children with a confirmed SCD diagnosis were included in the study by their referring doctor. Then, they were interviewed by phone about their socioeconomic status, about the impact of the disease on their lives and about their analgesic and psychoactive drug use. Results The study population consisted of 872 patients (28% were minors). Seventy-two percent of adults were active, and all minors were in school. Many patients presented criteria of severe SCD. Seventy-five percent were homozygous SS, 15% were double heterozygotes SC and 8% were heterozygotes Sβthal, 87% received specific treatment, 58% were hospitalized at least once for vaso-occlusive crisis in the past 12 months, and the number of analgesic drugs taken averaged 3.8. Seventy-five percent of patients reported academic or professional consequences related to their SCD, and 52% reported social consequences. Conclusions The impact of SCD on patients’ lives can be significant, nevertheless their social integration seems to be maintained. We highlighted respect of recommendations regarding analgesic treatments and only a few patients used tobacco, alcohol or cannabis. Trial registration Clinical Trials, NCT02580565; https://clinicaltrials.gov/ Registered 16 October 2015.
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Affiliation(s)
- Marie Gerardin
- Service de Pharmacologie Clinique, Centre Hospitalier Universitaire de Nantes, Nantes, France
| | - Morgane Rousselet
- Service de Pharmacologie Clinique, Centre Hospitalier Universitaire de Nantes, Nantes, France
- Service d’Addictologie et de Psychiatrie, Centre Hospitalier Universitaire de Nantes, Nantes, France
- INSERM U1246 SPHERE “Methods in Patient-Centered Outcomes and Health Research”, Universités de Nantes et Tours, Nantes, France
| | - Marie-Laure Couec
- Service de Pédiatrie et d’Oncologie Pédiatrique, Centre Hospitalier Universitaire de Nantes, Nantes, France
| | - Agathe Masseau
- Service de Médecine Interne, Centre Hospitalier Universitaire de Nantes, Nantes, France
| | - Marylène Guerlais
- Service de Pharmacologie Clinique, Centre Hospitalier Universitaire de Nantes, Nantes, France
| | - Nicolas Authier
- Service de Pharmacologie Médicale, Centre Hospitalier Universitaire de Clermont-Ferrand, Clermont-Ferrand, France
| | - Sylvie Deheul
- Service de Pharmacologie, Centre Hospitalier Universitaire de Lille, Lille, France
| | - Anne Roussin
- Service de Pharmacologie Médicale et Clinique, Centre Hospitalier Universitaire de Toulouse, Toulouse, France
| | - Joelle Micallef
- Service de Pharmacologie Clinique, Hôpital de la Timone, Assistance Publique-Hôpitaux de Marseille, Marseille, France
| | - Samira Djezzar
- Centre d’Evaluation et d’Information sur la Pharmacodependence—Addictovigilance de Paris, Hôpital Fernand Widal, APHP Paris, Paris, France
| | | | - Fanny Feuillet
- INSERM U1246 SPHERE “Methods in Patient-Centered Outcomes and Health Research”, Universités de Nantes et Tours, Nantes, France
- Plateforme de Biométrie, Centre Hospitalier Universitaire de Nantes, Nantes, France
| | - Pascale Jolliet
- Service de Pharmacologie Clinique, Centre Hospitalier Universitaire de Nantes, Nantes, France
- INSERM U1246 SPHERE “Methods in Patient-Centered Outcomes and Health Research”, Universités de Nantes et Tours, Nantes, France
| | - Caroline Victorri-Vigneau
- Service de Pharmacologie Clinique, Centre Hospitalier Universitaire de Nantes, Nantes, France
- INSERM U1246 SPHERE “Methods in Patient-Centered Outcomes and Health Research”, Universités de Nantes et Tours, Nantes, France
- * E-mail:
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15
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Abstract
Sickle hepatopathy is an umbrella term describing various pattern of liver injury seen in patients with sickle cell disease. The disease is not uncommon in India; in terms of prevalence, India is second only to Sub-Saharan Africa where sickle cell disease is most prevalent. Hepatic involvement in sickle cell disease is not uncommon. Liver disease may result from viral hepatitis and iron overload due to multiple transfusions of blood products or due to disease activity causing varying changes in vasculature. The clinical spectrum of disease ranges from ischemic injury due to sickling of red blood cells in hepatic sinusoids, pigment gall stones, and acute/chronic sequestration syndromes. The sequestration syndromes are usually episodic and self-limiting requiring conservative management such as antibiotics and intravenous fluids or packed red cell transfusions. However, rarely these episodes may present with coagulopathy and encephalopathy like acute liver failure, which are life-threatening, requiring exchange transfusions or even liver transplantation. However, evidence for their benefits, optimal indications, and threshold to start exchange transfusion is limited. Similarly, there is paucity of the literature regarding the end point of exchange transfusion in this scenario. Liver transplantation may also be beneficial in end-stage liver disease. Hydroxyurea, the antitumor agent, which is popularly used to prevent life-threatening complications such as acute chest syndrome or stroke in these patients, has been used only sparingly in hepatic sequestrations. The purpose of this review is to provide insights into epidemiology of sickle cell disease in India and pathogenesis and classification of hepatobiliary involvement in sickle cell disease. Finally, various management options including exchange transfusion, liver transplantation, and hydroxyurea in hepatic sequestration syndromes will be discussed in brief.
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Key Words
- AASLD, American Association for the Study of Liver Diseases
- ACLF, Acute on chronic liver failure
- ALF, Acute liver failure
- ALT, Alanine transaminase
- AST, Aspartate transaminase
- FFP, Fresh frozen plasma
- GIT, Gastrointestinal tract
- HAV, Hepatitis A virus
- HBV, Hepatitis B virus
- HCV, Hepatitis C virus
- HEV, Hepatitis E virus
- HIC, Hepatic iron content
- HbS, Sickle hemoglobin
- HbSS, Sickle cell disease homozygous
- INR, International normalized ratio
- PT, Prothrombin time
- RUQ, Right upper quadrant
- SC, Scheduled caste
- SCD, Sickle cell disease
- SCIC, Sickle cell intrahepatic cholestasis
- ST, Scheduled tribe
- TJLB, Transjugular liver biopsy
- UDCA, Ursodeoxycholic acid
- cholelithiasis
- intrahepatic cholestasis
- sickle cell hepatopathy
- sickle cholangiopathy
- sickle hepatic crisis
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Affiliation(s)
| | - Anil C. Anand
- Address for correspondence. Anil C Anand, Professor and Head, Department of Gastroenterology & Hepatology, Kalinga Institute of Medical Sciences, Bhubneshwar, India.
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16
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CAPRINI FR, MOTTA AB. The psychological impact on family caregivers of children and adolescents with sickle cell anemia. ESTUDOS DE PSICOLOGIA (CAMPINAS) 2021. [DOI: 10.1590/1982-0275202138e190168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Abstract Sickle cell anemia represents an aversive context, placing the family in a situation of vulnerability. This study investigated the psychological impact of sickle cell anemia on family caregivers of children and adolescents with this disease. A research with a quantitative approach followed by a survey was carried out, with a non-probabilistic sample of 100 caregivers who answered the instruments for measuring family functioning, disease-related stress, coping, anxiety, and depression. Clinical and sociodemographic characteristics were obtained from medical records and specific protocols. Caregivers of children with late diagnosis presented high disengaged coping scores, and minimum depression; early diagnosis was associated with mild depression. Family functioning domain scores were lower in families with younger children. Regression analyses showed that primary control coping indicates lower depression scores, and involuntaryengagement is a predictor of depression/anxiety. This study contributes to the understanding of the relationship between psychological, clinical, and sociodemographic variables in the context of sickle cell anemia.
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Issom DZ, Henriksen A, Woldaregay AZ, Rochat J, Lovis C, Hartvigsen G. Factors Influencing Motivation and Engagement in Mobile Health Among Patients With Sickle Cell Disease in Low-Prevalence, High-Income Countries: Qualitative Exploration of Patient Requirements. JMIR Hum Factors 2020; 7:e14599. [PMID: 32207692 PMCID: PMC7139429 DOI: 10.2196/14599] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2019] [Revised: 12/29/2019] [Accepted: 01/24/2020] [Indexed: 12/20/2022] Open
Abstract
Background Sickle cell disease (SCD) is a hematological genetic disease affecting over 25 million people worldwide. The main clinical manifestations of SCD, hemolytic anemia and vaso-occlusion, lead to chronic pain and organ damages. With recent advances in childhood care, high-income countries have seen SCD drift from a disease of early childhood mortality to a neglected chronic disease of adulthood. In particular, coordinated, preventive, and comprehensive care for adults with SCD is largely underresourced. Consequently, patients are left to self-manage. Mobile health (mHealth) apps for chronic disease self-management are now flooding app stores. However, evidence remains unclear about their effectiveness, and the literature indicates low user engagement and poor adoption rates. Finally, few apps have been developed for people with SCD and none encompasses their numerous and complex self-care management needs. Objective This study aimed to identify factors that may influence the long-term engagement and user adoption of mHealth among the particularly isolated community of adult patients with SCD living in low-prevalence, high-income countries. Methods Semistructured interviews were conducted. Interviews were audiotaped, transcribed verbatim, and analyzed using thematic analysis. Analysis was informed by the Braun and Clarke framework and mapped to the COM-B model (capability, opportunity, motivation, and behavior). Results were classified into high-level functional requirements (FRs) and nonfunctional requirements (NFRs) to guide the development of future mHealth interventions. Results Overall, 6 males and 4 females were interviewed (aged between 21 and 55 years). Thirty FRs and 31 NFRs were extracted from the analysis. Most participants (8/10) were concerned about increasing their physical capabilities being able to stop pain symptoms quickly. Regarding the psychological capability aspects, all interviewees desired to receive trustworthy feedback on their self-care management practices. About their physical opportunities, most (7/10) expressed a strong desire to receive alerts when they would reach their own physiological limitations (ie, during physical activity). Concerning social opportunity, most (9/10) reported wanting to learn about the self-care practices of other patients. Relating to motivational aspects, many interviewees (6/10) stressed their need to learn how to avoid the symptoms and live as normal a life as possible. Finally, NFRs included inconspicuousness and customizability of user experience, automatic data collection, data shareability, and data privacy. Conclusions Our findings suggest that motivation and engagement with mHealth technologies among the studied population could be increased by providing features that clearly benefit them. Self-management support and self-care decision aid are patients’ major demands. As the complexity of SCD self-management requires a high cognitive load, pervasive health technologies such as wearable sensors, implantable devices, or inconspicuous conversational user interfaces should be explored to ease it. Some of the required technologies already exist but must be integrated, bundled, adapted, or improved to meet the specific needs of people with SCD.
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Affiliation(s)
- David-Zacharie Issom
- Division of Medical Information Sciences, Geneva University Hospitals, Geneva, Switzerland.,Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - André Henriksen
- Department of Community Medicine, UiT - The Arctic University of Norway, Tromsø, Norway
| | | | - Jessica Rochat
- Division of Medical Information Sciences, Geneva University Hospitals, Geneva, Switzerland.,Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Christian Lovis
- Division of Medical Information Sciences, Geneva University Hospitals, Geneva, Switzerland.,Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Gunnar Hartvigsen
- Department of Computer Science, UiT - The Arctic University of Norway, Norway, Tromsø, Norway
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18
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Khan SA, AlSiny F, Makki A, Ali A, AlAnsari I, Khan S. Socioeconomic status dependent medical complexities in children with sickle cell disease in Saudi Arabia. Saudi J Biol Sci 2020; 27:1781-1787. [PMID: 32565696 PMCID: PMC7296505 DOI: 10.1016/j.sjbs.2020.03.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2019] [Revised: 02/23/2020] [Accepted: 03/04/2020] [Indexed: 12/13/2022] Open
Abstract
A look into the associations of socioeconomic status (SES) with prevalence of various complications in sickle cell disease (SCD) is necessary, for an improvement of societal norms, governmental health policies and strategies. We therefore studied the influence of SES indices on certain hematological and clinical parameters in children with SCD in Saudi Arabia. We included 32 female and 33 male patients aged 5–16 years, who were classified based upon their family income. Family monthly income was divided into 4 categories from lowest to highest, with socioeconomic class1 having low earnings of <5000 SAR; the middle income class divided further into class 2 with earnings >5000–10,000 SAR, and class 3 with earnings >10,000–15,000 SAR; and the higher income class 4 with earnings of >15,000 SAR. The assessment indices used were, the frequency of vaso-occlusive crisis (VOC), adverse events, and hematological parameters. A higher percentage of children affected with the disease were from class1, which is the low socio-economic class. It was found that the percentage of frequency of VOC pain crisis, and adverse events was higher in social class 1 patients than in the classes 2, 3, and 4. Also, the age group 5–10 years appeared more susceptible to adverse events and VOC. Our findings suggest the need to conduct future larger studies, to deduce the modifying influence of disparity in SES on certain clinical and hematological indices in children with SCD.
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Affiliation(s)
- Shahida Aziz Khan
- Applied Nutrition Group, King Fahd Medical Research Center, King Abdulaziz University, Jeddah, Saudi Arabia
- Department of Medical Laboratory Technology, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
- Corresponding author at: King Fahd Medical Research Center, King Abdulaziz University, P.O. Box 80216, Jeddah 21589, Saudi Arabia.
| | - Fayza AlSiny
- Department of Pediatrics, Faculty of Medicine, King Abdulaziz University Hospital, Jeddah, Saudi Arabia
| | - Ahmad Makki
- Applied Nutrition Group, King Fahd Medical Research Center, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Ashraf Ali
- Applied Nutrition Group, King Fahd Medical Research Center, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Ibtehal AlAnsari
- Applied Nutrition Group, King Fahd Medical Research Center, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Sarah Khan
- Applied Nutrition Group, King Fahd Medical Research Center, King Abdulaziz University, Jeddah, Saudi Arabia
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19
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Sickle Cell Disease and Pregnancy. Mediterr J Hematol Infect Dis 2019; 11:e2019040. [PMID: 31308916 PMCID: PMC6613624 DOI: 10.4084/mjhid.2019.040] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2019] [Accepted: 05/30/2019] [Indexed: 01/19/2023] Open
Abstract
Sickle cell disease (SCD) is the most common inherited hemoglobinopathy and is associated with increased risk of complications and early mortality. Nowadays, with improved health care facilities, antibiotic prophylaxis, vaccination, and availability of drugs like hydroxyurea, the life expectancy of SCD patients has improved. More women are reaching reproductive age group and are expressing their desire to reproduce. Though SCD adversely affects pregnancy, leading to increased incidence of maternal and perinatal complications like pre-eclampsia, preterm labor, IUGR, abortions etc., adequate care throughout pregnancy ensures a better outcome. Also, recent advancements in the fields of prenatal diagnosis and preimplantation genetic diagnosis, help couples suffering from SCD to have a healthy baby. This paper focuses on the effects of SCD on pregnancy outcomes and effective management of complications during pregnancy, also comparing maternal and perinatal outcomes in studies conducted in different countries. The second part of the paper summarizes pregnancy management in SCD for better maternal and fetal outcomes.
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