Acute sickle cell syndromes in Nigerian adults

Ibidapo, M O; Akinyanju, O. O.

doi:10.1046/j.1365-2257.2000.00292.x

Cited by 33 publications

(30 citation statements)

References 13 publications

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“…The age and sex distribution of subjects in these series are similar to those seen with vascular occlusive diseases (6)(7)16,17). The relative difference in sex ratio in subjects below 40 years and those above 40 years is noteworthy.…”

Section: Discussionsupporting

confidence: 54%

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Neovascular Glaucoma in a Nigerian African population

Ashaye

Adeoti²

2007

E Af Med Jrnl

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Objective: To determine the ocular and systemic factors associated with neovascular glaucoma (NVG) in an African population. Design: Hospital based cross sectional study. Setting: Eye clinic, Department of Ophthalmology, University College Hospital, Ibadan, Nigeria. Subjects: Sixty one consecutive patients with clinical diagnosis of NVG seen between January 1995 and December 1999 had a complete ocular evaluation. Results: Among the 61 subjects studied with an identifiable aetiological factor presumably causing neovascular glaucoma, 82% had associated posterior segment diseases producing ischaemia. These were retinal venous obstruction (78.7%), retinal arterial occlusion (1.6%). Those with no identifiable vaso-occlusive disease had couching (11.5%), aphakia with vitreous loss (3.3%) and chronic uveitis (1.6%). Systemic arterial hypertension was present in 62.3% while diabetes mellitus was present in only 8.3% of the subjects studied. Chronic uveitis and penetrating eye injury were infrequently diagnosed. Chronic open angle glaucoma was present in the other eye of 37.7% of subjects. Neovascular glaucoma was unilateral in 95.1% of subjects. 84.4% of affected eyes were blind on presentation. Males outnumbered females among subjects with NVG above 40 years, while females outnumbered males in the subjects below 40 years of age. Eyes of that were couched constitute a significant proportion of subjects with neovascular glaucoma. Conclusion: Medical conditions such as systemic hypertension, diabetes and ocular conditions like retinal vein, retinal artery occlusion, couching and glaucoma were associated with NVG. Most of these ocular and systemic associations should be identified early and treated to prevent neovascular glaucoma in the other eye of the subject.

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Section: Discussionsupporting

confidence: 54%

“…These were investigated. It is interesting however that no subject in this series had sickle cell disease even when the prevalence of sickle cell disease in the population is high (16). NVG has been reported to occur infrequently in subjects with proliferative sickle retinopathy (9).…”

Section: Discussionmentioning

confidence: 99%

Neovascular Glaucoma in a Nigerian African population

Ashaye

Adeoti²

2007

E Af Med Jrnl

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“…It is also an established fact that infections and malaria are among the most common triggers of different types of crisis necessitating admissions in children with SCD 21,. 22Vaso-occlusive crisis was the most frequently diagnosed clinical phenotype among patients in this study, similar to results from work carried out by Ibidapo et al and Olabode et al in Lagos and Ibadan, Nigeria respectively23,24. This finding buttresses the earlier mentioned role of malaria and infections as triggers of crisis in SCD21,22.…”

Section: Discussionsupporting

confidence: 89%

Prescription audit in a paediatric sickle cell clinic in South-West Nigeria: A cross-sectional retrospective study

et al. 2018

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BackgroundSickle cell disease (SCD) is a genetic haematological disorder that affects millions of people around the world especially people of African heritage. The treatment of the symptoms of SCD includes the use of analgesics, antibiotics, and anti-malarial drugs. Studying the pattern of drug prescription is a veritable tool for establishing the current practice and how it conforms to existing guidelines.ObjectivesThe main objective of this study was to assess the pattern of drug prescription in children with sickle cell disease (SCD) attending the paediatric outpatients' clinic of a tertiary care centre in Ado-Ekiti, South-West Nigeria.MethodsThis was a cross-sectional retrospective study carried out using the medical records of all patients with SCD who attended the paediatric outpatient clinic of the teaching hospital between January 1 and December 31, 2014. The information retrieved from the case notes included the bio-demographic data, associated co-morbid conditions and the list of prescribed drugs.ResultsA total of 202 SCD patients aged below 18 years were seen in the clinic during the study period with males accounting for 61.9% of them. The mean age of all patients was 6.9 ±3.8 yrs. A total of 1015 medications were prescribed during the study period giving a mean of 5.02 ± 1.9. Vitamins/micronutrients, anti-malarial drugs, antibiotics and analgesics accounted for 41.4%, 29.0%, 15.7% and 13.9% of all prescribed drugs respectively. Antibiotics from the penicillin group were the most commonly prescribed followed by macrolides and cephalosporins while Ibuprofen (60.3%) and Acetaminophen (32.6%) were the commonly prescribed analgesics.ConclusionHigh rate of antibiotic prescription, low use of opioid analgesics and non-prescription of prophylactic penicillin/pneumococcal vaccination were the main findings in this study. There is need for the introduction of standard treatment protocols for this group of patients.

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“…2 Although malaria is widely viewed as a major problem in African children with SCA, 1,22,24 the supportive evidence is inconclusive. There is no doubt that such subjects can develop severe and fatal malaria [24][25][26][27][28][29] ; however, their risk relative to those without the disease remains unknown. Most existing studies have been small and uncontrolled and have focused on children whose SCA has already been confirmed, and the many biases of this approach make the results of such studies difficult to interpret.…”

Section: Discussionmentioning

confidence: 99%

High mortality from Plasmodium falciparum malaria in children living with sickle cell anemia on the coast of Kenya

McAuley

Webb

Makani

et al. 2010

Blood

122

109

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Although malaria is widely considered a major cause of death in young children born with sickle cell anemia (SCA) in sub-Saharan Africa, this is poorly quantified. We attempted to investigate this question through 4 large case-control analyses involving 7164 children living on the coast of Kenya. SCA was associated with an increased risk of admission to hospital both with nonmalaria diseases in general (odds ratio [OR] ‫؍‬ 4.17; 95% confidence interval [CI], 1.95-8.92; P < .001) and with invasive bacterial diseases in particular (OR ‫؍‬ 8.73; 95% CI, 4.51-16.89; P < .001). We found no evidence for a strongly increased risk of either uncomplicated malaria (OR ‫؍‬ 0.43; 95% CI, 0.09-2.10; P ‫؍‬ .30) or malaria complicated by a range of well-described clinical features of severity (OR ‫؍‬ 0.80; 95% CI, 0.25-2.51; P ‫؍‬ .70) overall; nevertheless, mortality was considerably higher among SCA than non-SCA children hospitalized with malaria. Our findings highlight both the central role that malaria plays in the high early mortality seen in African children with SCA and the urgent need for better quantitative data. Meanwhile, our study confirms the importance of providing all children living with SCA in malaria-endemic areas with effective prophylaxis. (Blood. 2010;116(10):1663-1668) IntroductionThe common causes of morbidity and mortality in children living with sickle cell anemia (SCA) in developed countries have been well documented through projects, such as the Cooperative Study of Sickle Cell Disease in the United States and the Jamaican Cohort study. Nevertheless, surprisingly little research has been conducted in Africa, 1-3 where more than 230 000 children with SCA, approximately 80% of the global burden, are born every year. 4 Although malaria is widely considered a major cause of death in African children with SCA, 1,5-7 this assumption is supported by surprisingly few data. Most reports have involved small, hospital-based studies and have lacked control data that enable comparisons of risk to be made with non-SCA subjects. 1 Perhaps the strongest evidence comes from the Garki project, conducted in northern Nigeria during the 1970s, which reported a nonsignificant trend toward higher survival of children with SCA in an area exposed to intensive malaria control. 8 However, studies suggesting that malaria is an important cause of death in children with SCA are balanced by others that show the opposite: children with SCA might even be less susceptible to malaria than those without the disease. 6,[9][10][11][12][13] Determining the true risk of death from malaria in subjects with SCA is important for several reasons. From a policy perspective, documenting an association between SCA and malaria death would provide strong justification for early-life SCA screening and the targeted prescription of effective malaria prophylaxis. Conversely, if the risk of malaria-specific death was not elevated, alternative approaches to prophylaxis and treatment might be considered. Recently, we reported that malaria was a rare cause...

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Acute sickle cell syndromes in Nigerian adults

Cited by 33 publications

References 13 publications

Neovascular Glaucoma in a Nigerian African population

Neovascular Glaucoma in a Nigerian African population

Prescription audit in a paediatric sickle cell clinic in South-West Nigeria: A cross-sectional retrospective study

High mortality from Plasmodium falciparum malaria in children living with sickle cell anemia on the coast of Kenya

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