Fever among Children with Sickle-Cell  Disease: Findings from the General  Pediatric Ward of the Owendo Pediatric Hospital in Libreville, Gabon

Koko, J.; Gahouma, D.; Ategbo, S; Seilhan, Cathérine; Pambou, Armelle; Moussavou, A.

doi:10.4236/ojped.2014.44036

Cited by 4 publications

(5 citation statements)

References 25 publications

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“…For the population studied in this cohort, there seems to be an indication for the use of a broad spectrum cephalosporin in combination with either a macrolide or quinolone for empiric coverage of febrile patients. Incidence of acute osteomyelitis, meningitis, or acute cholecystitis were lower than those reported by Williams in Kenya [34], Akar in Kowet [35], Mava in Nigeria [36], and Koko in Gabon [37]. This difference can be explained by a difference in immunization status between our population and those studied by others.…”

Section: Discussioncontrasting

confidence: 79%

Severe Bacterial and Plasmodium Falciparum Infections in Febrile Children with Sickle Cell Disease Receiving Organized Specialty Care in a Referral Center in Sub-Saharan Africa: lessons for Clinical Practice

et al. 2019

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The burden of severe bacterial and malaria infections in children with SCD has been reduced through the use of prophylactic antibiotics and chemoprevention with Sulfadoxine-pyrimethamine. However, such therapies have the potential to promote bacterial and parasitic resistance. To our knowledge, no study has been conducted to determine whether systematic use of prophylactic antimicrobials in children with SCD has an impact on resistance patterns in sub-Saharan Africa. The aim of our study was to determine the incidence and the outcome of severe bacterial and P. falciparum infections in this context. 231 children with SCD and new onset fever associated with either acute pneumonia, urinary tract infection, cholecystitis, meningitis, acute osteomyelitis, or P. falciparum infections were entered into the study. The children in the cohort were an average age of 93 months (± 44 months) and were all followed in a referral center in Western Africa. The 231 children represented 36.67% of the patients regularly followed in the center during the study period and included 183 SS, 26 SC, 12 S?°thal, 10 S?+thal. There were 144 boys and 87 girls in the cohort. The incidence of severe bacterial and Plasmodium falciparum infections were lower than those reported in the general pediatric or sickle cell population in the absence of regular follow-up (ie 5.2, 1.4, 1.0 and, 4.1 per 1000 person/month for urinary tract infections, acute pneumonia, bacteremia and P. falciparum malaria respectively). We observed bacterial strains to be mainly in the Enterobacteria family with high levels of antibiotic resistance. No cases of Streptococcus pneumoniae bacteremia were found. Sulfadoxine-pyrimethamine resistance was observed at high levels. In light of these findings, prophylactic antibiotherapy and antimalarial chemoprevention guidelines in sickle-cell children should be revisited in the context of organized SCD care in sub-Saharan Africa.

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Section: Discussioncontrasting

confidence: 79%

Severe Bacterial and Plasmodium Falciparum Infections in Febrile Children with Sickle Cell Disease Receiving Organized Specialty Care in a Referral Center in Sub-Saharan Africa: lessons for Clinical Practice

et al. 2019

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“…[8]. In this Gabonese study, it was reported that fever was associated with plasma infection in 43.5% and 55.25% of cases of fever without known etiologies [56,64]. An association of bacteremia with low hemoglobin levels was revealed in a study in Tanzania.…”

Section: Sickle Cell Anemia and Invasive Bacteremias Or Infectionsmentioning

confidence: 81%

Bacterial Infection in the Sickle Cell Population: Development and Enabling Factors

et al. 2023

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The high frequency of bacterial infections represents a major threat to public health. In developing countries, they are still responsible for significant morbidity and mortality in pediatric populations with sickle cell disease, particularly in children under 5 years of age. Indeed, they have an increased susceptibility to bacterial infections due to their immune deficiency. This susceptibility is even greater for pneumococcal and salmonella infections. In addition, the underdevelopment of some countries and socio-economic factors increases this condition. This review examines the common and specific factors leading to infections in people with sickle cell disease in different types of developed and undeveloped countries. The threat of bacterial infections, particularly those caused by S. pneumoniae and Salmonella, is of increasing concern due to the rise in bacterial resistance to antibiotics. In light of this disturbing data, new strategies to control and prevent these infections are needed. Solutions could be systematic penicillin therapy, vaccinations, and probabilistic antibiotic therapy protocols.

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“…A genetic hematological disorder, SCD affects 7% of the global population and 4.2% of Saudi Arabia’s population [ 2 , 3 ]. Fever is a significant condition in children with SCD, often indicating serious underlying conditions requiring medical attention [ 4 ]. SCD children face an increased risk of invasive infection, morbidity, and mortality due to splenic dysfunction [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

Causes and Recommendations for Fever in Sickle Cell Pediatric Patients in the Emergency Department: A Single-Center Study

Halawani

2023

Cureus

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Background Children with sickle cell disease (SCD) are prone to bacterial infections, culminating in life-threatening incidences. Early evaluation of children with SCD helps in effective management and support. Methodology A retrospective study was conducted using medical records for febrile episodes in SCD children ≤14 years of age who presented to the Emergency Department of King Abdulaziz University Hospital, Jeddah, Kingdom of Saudi Arabia from 2015 to 2018. A total of 304 episodes were encountered in the Emergency Department during this period. Results The clinical diagnosis included confirmed bacterial infection (4.5%), presumed bacterial infection (24.6%), and those without bacterial infection (57.5%). The incidence of bacteremia was found in 3.0% of the episodes and urinary tract infection in 1.5%. The most common isolates were Staphylococcus aureus , Streptococcus viridians , Salmonella species, and Escherichia coli . Overall, 52% of the febrile episodes resulted in hospitalization, of which 74% had at least one prior hospitalization. The hospitalization probability across the two sexes was statistically insignificant (p = 0.029). The likelihood of admission increased with age (p < 0.001) and temperature (p < 0.001). The study included 140 children with SCD who had at least one abdominal sonogram performed at our hospital between 2015 and 2018. There were changes in the radiographic appearance of the spleen in patients with SCD who were expected to undergo autosplenectomy between the ages of five and 17 years. Conclusions The study envisages the risk associated with febrile episodes and the prompt recovery of such patients through clinical confirmations. Parents should be aware and observant of the complications of infectious illnesses for speedy medical assistance.

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Fever among Children with Sickle-Cell Disease: Findings from the General Pediatric Ward of the Owendo Pediatric Hospital in Libreville, Gabon

Cited by 4 publications

References 25 publications

Severe Bacterial and Plasmodium Falciparum Infections in Febrile Children with Sickle Cell Disease Receiving Organized Specialty Care in a Referral Center in Sub-Saharan Africa: lessons for Clinical Practice

Severe Bacterial and Plasmodium Falciparum Infections in Febrile Children with Sickle Cell Disease Receiving Organized Specialty Care in a Referral Center in Sub-Saharan Africa: lessons for Clinical Practice

Bacterial Infection in the Sickle Cell Population: Development and Enabling Factors

Causes and Recommendations for Fever in Sickle Cell Pediatric Patients in the Emergency Department: A Single-Center Study

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