Hematological parameters in Ghanaian sickle cell disease patients

Abstract

BackgroundEffective treatment and management of sickle cell disease (SCD) has been a challenge in Africa over the years. Hematological parameters are very useful profiles in the effective management of the disease. However, there is scarcity of studies on the hematological parameters of SCD in Ghana. This study aimed at determining hematological parameters among SCD patients with vaso-occlusion, those in the steady state as well as healthy controls at a teaching hospital in Ghana.MethodologyThis was a cross-sectional study involving a total of 628 subjects, including 148 HbAA controls, 208 HbSS patients in steady state, 82 HbSC patients in steady state, 156 HbSS patients in vaso-occlusive crises (VOC), and 34 HbSC patients in VOC. Venous blood sample was collected from all study participants. A full blood count was done within 2 hours of collection, and hemoglobin (Hb) concentration, packed cell volume, red blood cell (RBC) concentration, mean corpuscular Hb, mean cell volume, mean corpuscular Hb concentration, and white blood cells (WBC) and platelet (PLT) counts were recorded.ResultsWBC and PLT counts were significantly higher in both female and male patients with SCD, compared with their healthy counterparts (P<0.05). The level of WBC was, however, significantly higher in patients with HbSS VOC among the SCD patients (P<0.001). Levels of Hb, RBC, and hematocrit were significantly higher in the controls (P<0.001). There was no significant difference in mean cell Hb among male patients with SCD (P=0.274) and female patients with SCD (P=0.5410).ConclusionThe SCD patients had lower Hb and RBC than the controls; however, higher PLT and WBC are noted in various status of SCD, possibly reflecting spleen effect in these patients. Further studies are needed to confirm these findings.

Hematological profile of sickle cell disease in Chhattisgarh

“…It was 2.92±0.87 in males and was 2.91±0.61 in females, p value being 0.96, insignificant. Similar values of RBC counts were seen in the study by Boasiako et al 9 Higher RBC counts were reported in studies by Jawalkar et al, Nagose et al, Jadhav et al and Rao et al, whereas lower RBC counts were seen in the study by Kohchale et al [6][7][8]10,11 Significant positive correlation was found in present study in both sexes between total RBC count and total hemoglobin, p value being 0.0023, in males and <0.00001 in females. These values were similar to the study by Shrikhande et al 12 Mean±SD of mean corpuscular volume (MCV), was 85.92±9.65 and it was 87.16±8.42 in males and 83±11.86 in females, p value between the two sexes being 0.16, insignificant.…”

“…These values were similar to the study by Shrikhande et al 12 Mean±SD of mean corpuscular volume (MCV), was 85.92±9.65 and it was 87.16±8.42 in males and 83±11.86 in females, p value between the two sexes being 0.16, insignificant. Similar values of MCV were seen in studies by Nagose et al and Boasiako et al 7,9 Lower MCV values were reported in the studies by Rao et al, Jawarkar et al and Kohchale et al whereas higher MCV values were reported by Jadhav et al 6,8,10,11 An insignificant and negative correlation was seen in present study in both sexes between haemoglobin and mean corpuscular volume, with a p value of 0.96 in males and 0.08 in females, similar were findings in study by Shrikhande et al 12 In sickle cell disease Vit B 12 and folic acid are at a critical borderline levels and increased demands on erythropoesis due to the chronic haemolytic process leads to macrocytosis and higher MCV. Lower MCV values in some of the studies could be due to coexisting Iron deficiency anemia and alpha thalassemia.…”

“…The p value between males and females came out to be 0.16, insignificant. Similar values of MCH was seen in the studies by Nagose et al, Boasiako et al, Rao et al and Jadhav et al [6][7][8][9] Lower values in MCH were reported by Kohchale et al and Jawarkar et al 9,10 Mean±SD of mean corpuscular haemoglobin concentration (MCHC) (g/dl) was 32.64±3.95, it was 32.87±4.07 in males and 32.23±3.77 in females, p value between females and males came out to be 0.60, again insignificant. Similar were values of MCHC reported in studies by Nagose et al, Boasiako et al, Rao et al and Jawarkar et al [7][8][9]11 Higher MCHC were reported in the studies by Kohchale et al and lower MCHC was reported in study by Jadhav et al 6,10 Mean±SD of HbF (%) was 18.21±5.72, it was 18.79±5.21 in males and 16.86±6.76 in females.…”

“…Complete blood count (CBC) was measured using hematology autoanalyser. [6][7][8][9][10][11] Total RBC counts (million/mm 3 ) was low in our study, it was 2.92±0.79. It was 2.92±0.87 in males and was 2.91±0.61 in females, p value being 0.96, insignificant.…”

Patterns and patient factors associated with loss to follow-up in the Muhimbili Sickle Cell Cohort, Tanzania

“…Hematological parameters are an effective mechanism to understand the correlation of clinical outcomes in individuals with sickle cell. There have been several studies on hematological parameters in sickle cell patients, but we went further to see if there is any relationship with LTFU patterns [25][26][27] . Patients whose hematocrit or MCV were above the average were more likely to be LTFU than those below average.…”