Comparison of Patients from Nigeria and the USA Highlights Modifiable Risk Factors for Sickle Cell Anemia Complications

Akingbola, Titilola S.; Tayo, Bamidele O.; Bl, Salako; Layden, Jennifer E.; Hsu, Lewis L.; Cooper, Richard S.; Saraf, Santosh L.

doi:10.3109/03630269.2014.927363

Cited by 24 publications

(19 citation statements)

References 27 publications

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“…The current study confirms this finding, even in a SCA cohort, a similar finding reported in developed countries (Pegelow et al, 1997; Desai et al, 2012) and in Africa (Akingbola et al, 2014). With the improved survival of patients with SCA, the incidence of hypertension is expected to rise, thus screening and awareness are required to prevent the expected complications.…”

Section: Discussionsupporting

confidence: 92%

Rates and risk factors of hypertension in adolescents and adults with sickle cell anaemia in Tanzania: 10 years’ experience

et al. 2016

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Summary Data on the magnitude and risk factors for hypertension in sickle cell anaemia (SCA) are limited. A retrospective analysis of individuals with SCA aged ≥15 years enrolled from 2004–2014 at Muhimbili National Hospital, Tanzania was conducted to determine the prevalence, incidence and risk factors for hypertension. A total of 1013 individuals with SCA were analysed, of whom 571(56%) were females. The median age [interquartile range] was 17 [15–22] years. Four hundred and forty-one (44%) of the patients had relative hypertension [systolic blood pressure (SBP) 120–139 mmHg or diastolic blood pressure (DBP) 70–89 mmHg], and 79 (8%) had hypertension (SBP ≥ 140 mmHg or DBP ≥ 90 mmHg). The incidence of hypertension was 64/1000 person years of observation and the 5-year survival rate was 0·71 [95% confidence interval (CI): 0·67–0·75]. In multivariate analysis, age>18 years, Hazard ratio (HR) 1·50 (95% CI: 1·03–2·18); pulse pressure, HR 0·64 (95% CI: 0·42 to 0·98); pulse rate, 1·02 (95% CI: 1·01–1·03); body mass index (BMI), HR 1·08 (95% CI: 1·03–1·13); blood transfusion, HR 2·50 (95% CI: 1·01–6·21) and haemoglobin, HR 1·12 (95% CI: 1·05–1·33) were independently associated with hypertension. In conclusion, despite the younger age, hypertension in this population was higher than that reported in others studies. Age, BMI, pulse pressure and haemoglobin were independently associated with hypertension in SCA.

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Section: Discussionsupporting

confidence: 92%

Rates and risk factors of hypertension in adolescents and adults with sickle cell anaemia in Tanzania: 10 years’ experience

et al. 2016

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“…None of the patients was on hydroxyurea during the duration of this study and this may be due to poor knowledge and perception of physicians towards its use and the issue of cost and its side effects. A recent comparative study among sickle cell patients from Nigeria and the USA showed significant lower use of hydroxyurea among the Nigerian cohort50. Also the locally developed anti-sickling agent, Ciklavit®, which has been found to be effective in reducing sickling episodes, was not prescribed for any of the patients during the study51.…”

Section: Discussionmentioning

confidence: 99%

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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“…The severity of anemia, a history of recurrent acute chest syndrome, obesity, and elevated blood pressure are all considered independent risk factors for the development of stroke (Akingbola et al, 2014;Ohene-Frempong et al, 1998;Wang et al, 2008). Other risk factors include prior transient ischemic attack, low steady-state hemoglobin levels, hypertension, and high leukocyte counts (Ohene-Frempong et al, 1998).…”

Section: Stroke In Scdmentioning

confidence: 99%

Genetics of Sickle Cell-Associated Cardiovascular Disease: An Expert Review with Lessons Learned in Africa

Geard

Pule

Chelo

et al. 2016

OMICS: A Journal of Integrative Biology

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Sickle cell disease (SCD) vastly impacts the African continent and is associated with cardiovascular diseases. Stroke, kidney disease, and pulmonary hypertension are considered as proxies of severity in SCD with several genomic loci implicated in their heritability. The present expert review examined the current data on epidemiology and genetic risk factors of stroke, pulmonary hypertension, and kidney disease associated with SCD, as indexed in PubMed Ò and Google Scholar Ò . Studies collectively show that stroke and kidney disease each affect *10% of SCD patients, with pulmonary hypertension displaying a higher prevalence of 30% among adults with SCD. There is some evidence that these epidemiology figures may be an underestimate in SCD patients living in Africa. A modest number of publications have identified genetic factors involved in pathways regulating inflammation, coagulation, cell adhesion, heme degradation, a-globin and c-globin production, and others, which contribute to the development risk of targeted cardiovascular phenotypes. However, in most cases, these studies have not been validated across populations. There is therefore an urgent need for large-scale genome-wide association, wholeexome and whole-genome studies, and multiomics research on cardiovascular diseases associated with SCD, particularly in Africa, to allow for proportional investment of global research funding on diseases that greatly impact the African continent. Ultimately, this will cultivate socially responsible research investments and identification of at-risk individuals with improved preventive medicine, which should be a cornerstone of global precision medicine.

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Comparison of Patients from Nigeria and the USA Highlights Modifiable Risk Factors for Sickle Cell Anemia Complications

Cited by 24 publications

References 27 publications

Rates and risk factors of hypertension in adolescents and adults with sickle cell anaemia in Tanzania: 10 years’ experience

Rates and risk factors of hypertension in adolescents and adults with sickle cell anaemia in Tanzania: 10 years’ experience

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

Genetics of Sickle Cell-Associated Cardiovascular Disease: An Expert Review with Lessons Learned in Africa

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