Profils épidemiologiques, cliniques et hématologiques de la drépanocytose homozygote SS en phase inter critique chez l’enfant à Ziguinchor, Sénégal

Thiam, Lamine; Dramé, Assane; Coly, Isabelle Zokébé; Diouf, Fatou; Seck, Ndiogou; Boiro, Djibril; Ndongo, Aliou Abdoulaye; Basse, Idrissa; Niang, Babacar; Dème, I.; Ly,; Sylla, A.; Diagne, Ibrahima; Ndiaye, Ousmane

doi:10.11604/pamj.2017.28.208.14006

Cited by 15 publications

(13 citation statements)

References 10 publications

(13 reference statements)

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“…These results are consistent with those of other authors who reported an average age of around 10 years in SCD patients and a first diagnosis at the age of 2 years or later [29][30][31][32][33][34]. VOC being also reported as the most frequent mode of first diagnosis [30,33,35,36].…”

Section: Discussionsupporting

confidence: 92%

Feasibility and Applicability of Standardized and Regular Follow-up of Sickle Cell Patients in a Remote Area of a Developing Country

Bm¹,

Dk²,

Yn³

et al. 2020

Preprint

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Background: Sickle cell disease (SCD) is the most common hemoglobinopathy in the Democratic Republic of Congo (DRC) and poses a public health problem. If, without clinical follow-up, more than 50% of children with SCD die before their 5th birthday. A regular medical follow-up is the first simple improvement that can be beneficial for SCD patients in a remote city of an African country. Method: A cohort of 143 children with SCD aged 10 years old (IQR [inter quartile range]: 6–15 years) (sex ratio male: female = 1.3) were clinically followed for 12 months without any specific intervention and then 12 months with a monthly medical visit, a biological follow-up and regular prophylaxis. A paired Student test and pairwise Wilcoxon test were used to compare study outcomes. Results: The median age of patients at the diagnosis of SCD was 2 years (IQR: 1–5). Anemia was noted in 100% of patients at inclusion, with severe and normocytic anemia in 80% of cases (n = 115). The implementation of standardized and regular follow-up has shown an increase in the annual mean hemoglobin level from the percentage of the low limit normal for the age from 54 to 77 % (p = 0.001), and a decrease of the lymphocytes count and spleen size (p < 0.001). The implementation of regular follow-up has also shown a significant decrease (p < 0.001) in the average annual number of hospitalizations and episodes with vaso-occlusive crises, blood transfusions, infections, and acute chest syndromes. Conclusions: This study showed that the regular follow-up of children with SCD and the application of SCD management recommendations are possible and applicable in the context of a remote city in a developing country. Simple and accessible measures included in conventional recommendations can reduce the morbimortality of these patients in remote areas if applied rigorously with regular follow-up.

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Section: Discussionsupporting

confidence: 92%

Feasibility and Applicability of Standardized and Regular Follow-up of Sickle Cell Patients in a Remote Area of a Developing Country

Bm¹,

Dk²,

Yn³

et al. 2020

Preprint

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“…Our observation that Sh - Sb hybrids are associated with higher odds of hepatomegaly relies on a relatively small subset of data ( n = 42). Although we accounted for urogenital and intestinal infections presence and intensity, age, sex, and study site, possible sampling biases for other confounders prevalent in Senegal could not be excluded, such as pulmonary hypertension [ 53 ], hepatitis B [ 54 ], sickle-cell disease [ 55 ] or malnutrition [ 56 ]. Although malaria is a major cause of hepatomegaly, the prevalence of malaria is very low in the study area and therefore is not a likely confounder, at least amongst the children.…”

Section: Discussionmentioning

confidence: 99%

Hybridized Zoonotic Schistosoma Infections Result in Hybridized Morbidity Profiles: A Clinical Morbidity Study amongst Co-Infected Human Populations of Senegal

et al. 2021

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Hybridization of infectious agents is a major emerging public and veterinary health concern at the interface of evolution, epidemiology, and control. Whilst evidence of the extent of hybridization amongst parasites is increasing, their impact on morbidity remains largely unknown. This may be predicted to be particularly pertinent where parasites of animals with contrasting pathogenicity viably hybridize with human parasites. Recent research has revealed that viable zoonotic hybrids between human urogenital Schistosoma haematobium with intestinal Schistosoma species of livestock, notably Schistosoma bovis, can be highly prevalent across Africa and beyond. Examining human populations in Senegal, we found increased hepatic but decreased urogenital morbidity, and reduced improvement following treatment with praziquantel, in those infected with zoonotic hybrids compared to non-hybrids. Our results have implications for effective monitoring and evaluation of control programmes, and demonstrate for the first time the potential impact of parasite hybridizations on host morbidity.

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“…Anemia of any origin is frequent in Africa, which explains why its management is well known. This is essential because acute anemia is responsible for a high mortality rate in sickle cell patients in sub-Saharan Africa [ 31 , 32 ]. Its prevention and effective management dictate specific strategies that are adapted to the African context [ 24 ].…”

Section: Discussionmentioning

confidence: 99%

Sickle Cell Disease in the Democratic Republic of Congo: Assessing Physicians’ Knowledge and Practices

2020

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Background: Sickle cell disease is a major public health issue in the Democratic Republic of Congo (DRC), but it is still poorly understood by health professionals. The objective of this study was to assess the knowledge and practices of Congolese physicians treating sickle cell disease (SCD), in order to identify the areas for improvement in clinical care. Methods: This was a descriptive observational study conducted among Congolese physicians using a questionnaire. Participants were evaluated using a pre-established answer grid. Results: A total of 460 physicians participated, including 81 women (18%), with an average age of 35 years (range 25–60 years). Most physicians were general practitioners. Although self-assessment of their level of knowledge on SCD was estimated as average to good, less than half of the participants (n = 460; 46%) reported adequate management of vaso-occlusive crises, and only 1% of them had received specific training on SCD. Most physicians reported difficulties both in terms of diagnostic (65%) and management (79%) options of SCD patients. This study also showed that 85% of these physicians did not have access to the diagnostic tools for SCD. Conclusions: Insufficient knowledge on SCD and poor diagnostic and treatment options might contribute to increased morbidity and mortality of patients living in the DRC. Interventions aiming to improve physicians’ knowledge, patient follow-up, and treatment access are needed. Specific training alongside existing programs (HIV, malaria), early diagnosis of the disease, and the creation of patient advocacy groups should be implemented to improve SCD patient care.

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Profils épidemiologiques, cliniques et hématologiques de la drépanocytose homozygote SS en phase inter critique chez l’enfant à Ziguinchor, Sénégal

Cited by 15 publications

References 10 publications

Feasibility and Applicability of Standardized and Regular Follow-up of Sickle Cell Patients in a Remote Area of a Developing Country

Feasibility and Applicability of Standardized and Regular Follow-up of Sickle Cell Patients in a Remote Area of a Developing Country

Hybridized Zoonotic Schistosoma Infections Result in Hybridized Morbidity Profiles: A Clinical Morbidity Study amongst Co-Infected Human Populations of Senegal

Sickle Cell Disease in the Democratic Republic of Congo: Assessing Physicians’ Knowledge and Practices

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