The Acute Chest Syndrome in Cameroonian children living with sickle cell disease

Nansseu, Jobert Richie; Yanda, Anastasie Nicole Alima; Chelo, David; Tatah, Sandra; Awa, Hubert Désiré Mbassi; Seungue, Judith; Koki, Paul Olivier

doi:10.1186/s12887-015-0454-0

Cited by 14 publications

(15 citation statements)

References 30 publications

(55 reference statements)

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“…The prevalence of ACS among children with SCA presenting with fever in this study was 22·7%, which is comparable to figures from Jamaica (Wierenga et al , ), Oman (Jaiyesimi & Kasem, ), and Saudi Arabia (Hawasawi et al , ). This rate, however, differs from a recent report of 6% by Nansseu et al () from Cameroon partly because of differences in target groups or even differences in haplotypes between Uganda and Cameroon. The Saudi prevalence was not different from the current study, possibly because African haplotypes of sickle cell gene prevail in the Saudi western region (Alabdulaali, ).…”

Section: Discussioncontrasting

confidence: 91%

ACS in children with sickle cell anaemia in Uganda: prevalence, presentation and aetiology

et al. 2018

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ACS (ACS) is a serious complication of sickle cell anaemia (SCA). We set out to describe the burden, presentation and organisms associated with ACS amongst children with SCA attending Mulago Hospital, Kampala, Uganda. In a cross-sectional study, 256 children with SCA and fever attending Mulago Hospital were recruited. Chest X-rays, blood cultures, complete blood count and sputum induction were performed. Sputum samples were investigated by Ziehl-Nielsen staining, culture and DNA polymerase chain reaction (PCR) for Chlamydia pneumoniae. Of the 256 children, 22·7% had ACS. Clinical and laboratory findings were not significantly different between children with ACS and those without, besides cough and abnormal signs on auscultation. Among the 83 sputum cultures Streptococcus pneumoniae (12%) and Moraxella spp (8%), were the commonest. Of the 59 sputa examined with DNA PCR, 59·3% were positive for Chlamydia pneumoniae. Mycobacterium tuberculosis was isolated in 6/83 sputa. These results show that one in 5 SCA febrile children had ACS. There were no clinical and laboratory characteristics of ACS, but cough and abnormalities on auscultation were associated with ACS. The high prevalence of Chlamydia pneumoniae in children with ACS in this setting warrants the addition of macrolides to treatment, and M. tuberculosis should be differential in sub-Saharan children with ACS.

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Section: Discussioncontrasting

confidence: 91%

ACS in children with sickle cell anaemia in Uganda: prevalence, presentation and aetiology

et al. 2018

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“…SCA is the most prevalent hereditary haemoglobin disorder in Oman 5,6,12,13 . Furthermore, ACS is the leading cause of death among patients with SCA [7][8][9] .…”

Section: Discussionmentioning

confidence: 99%

Predictors of impending acute chest syndrome in patients with sickle cell anaemia

Alkindi

Al-Busaidi

Al-Salami

et al. 2020

Sci Rep

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Acute chest syndrome (AcS) is a major complication of sickle cell anaemia (ScA) and a leading cause for hospital admissions and death. We aimed to study the spectrum of clinical and laboratory features of AcS and to assess the predisposing factors and predictors of severity. A retrospective case-control cohort was studied by retrieving patient information from electronic medical records after ethical approval. One hundred adolescents and adults with SCA and hospital admissions for ACS were identified through the discharge summaries, along with 20 additional patients presenting with VOC, but without ACS (controls). Among the patients with ACS, fever (>38.5 °C), reduced oxygen saturation (<95) and asplenia significantly differed when compared to those of controls (p < 0.05, chi-squared test). The degree of severity was reflected in the use of non-invasive ventilation (NIV), simple and exchange transfusions, and the presence of bilateral pleural effusions and multi-lobar atelectasis/consolidation, which were significantly higher in the cases with ACS than in the controls. Lower haemoglobin (Hb) and high WBC counts were also significantly different between the two groups (p < 0.05, Student's t test). Using logistic regression, our study further demonstrated that asplenia, fever, and reduced O 2 saturation, along with low Hb and leukocytosis, were important predictors for the development of ACS. Sickle cell anaemia (SCA) is an autosomal recessive disorder characterized by a point mutation in codon 6 of the beta globin chain, where glutamic acid is replaced by valine, resulting in the formation of HbS with varied clinical manifestations 1. The abnormal Hb is insoluble and polymerizes when exposed to low O 2 tension, leading to the major clinical manifestations of SCA, including recurrent vaso-occlusive crisis (VOC), predisposition to infections and reduced red cell survival with anaemia 2. Sickle cell disease (SCD) is prevalent in sub-Saharan Africa and the Indian sub-continent, but human population mobility has spread the disorder throughout Europe, Asia and the Americas 3,4. SCD is highly prevalent in Oman, with an estimated sickle cell gene frequency of 5.8% and a prevalence of sickle cell traits and SCA in Omani children of 4.8% and 0.3%, respectively 5,6. It is thus estimated that one neonate of every 323 newborns in Oman has SCA 6. Acute chest syndrome (ACS) is defined as the presence of fever and/or new respiratory symptoms accompanied by the presence of a new pulmonary infiltrate on chest X-ray and is one of the most important causes of death and the second most common cause of hospitalization in SCA patients 7. In a retrospective study, ACS was found to be responsible for 69.6% of SCA ICU admissions and was associated with a 16% mortality rate 7. Furthermore, ACS is associated with a high risk of sickle cell-related mortality and morbidity, including prolonged hospitalization 8. Although the aetiology of ACS is multifactorial, the Cooperative Study of Sickle Cell Disease (CSSCD) in the United States identified...

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“…This Centre, which has been well described elsewhere [7], is a pediatric reference hospital receiving patients coming from all over the country and the rest of the Central African sub-region. Nearly 700 SCD patients are regularly followed-up, with an average of 400 hospitalizations per year.…”

Section: Methodsmentioning

confidence: 99%

Burden and spectrum of bacterial infections among sickle cell disease children living in Cameroon

et al. 2017

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BackgroundAlthough sickle cell disease (SCD) children are highly susceptible to bacterial infections (BIs), there is a dreadful lack of data related to the burden and spectrum of BIs in sub-Saharan Africa (SSA), the highest affected region with SCD. This study aimed to determine the burden and spectrum of BIs among SCD children hospitalized in a pediatric reference hospital in Cameroon, a SSA country.MethodsWe conducted a retrospective analysis of records of children hospitalized from November 2012 to August 2015 in the SCD unit of the Mother and Child Centre of the Chantal Biya Foundation, Cameroon. We enrolled all known SCD children aged 15 years or less, hospitalized for a suspicion of BI and who presented a positive culture of a body specimen.ResultsA total of 987 SCD children were hospitalized during the study period. Cultures were positive for 96 patients (9.7%) among whom 60.4% males. Ages ranged from 6 to 192 months with a median of 53 (Interquartile range (IQR) 21–101) months. For children no more covered by the Expanded Programme on Immunization, only 13 (18.8%) had received the Pneumo 23® and Meningo A&C® antigens, and 12 (17.4%), the Typhim vi® and the Haemophilus influenzae type b antigens; 58 children (84.1%) had received no vaccine. The specimen yielding positive cultures were: blood (70.7%), urine (13.1%), pus (9.1%), synovial fluid (4.1%), cerebrospinal fluid (2.0%), and bone fragment (1.0%). The different types of infection included: urinary tract infections (13.5%), myositis (8.3%), arthritis (6.3%), osteomyelitis (4.2%), and meningitis (2.1%); the site of infection was unidentified in 65.6% of cases. The main bacteria included: Salmonella sp. (28.1%), Staphylococcus sp. (18.8%), Klebsiella pneumoniae (17.7%), Escherichia coli (10.4%), Enterobacter sp. (5.2%), Acinetobacter sp. (4.2%), Streptococcus sp. (4.2%) and Serratia sp. (4.2%).ConclusionThis retrospective analysis revealed 9.7% cases of BIs, mainly caused by Salmonella sp. (28.1%), Staphylococcus sp. (18.8%), Klebsiella pneumoniae (17.7%), and Escherichia coli (10.4%).

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The Acute Chest Syndrome in Cameroonian children living with sickle cell disease

Cited by 14 publications

References 30 publications

ACS in children with sickle cell anaemia in Uganda: prevalence, presentation and aetiology

ACS in children with sickle cell anaemia in Uganda: prevalence, presentation and aetiology

Predictors of impending acute chest syndrome in patients with sickle cell anaemia

Burden and spectrum of bacterial infections among sickle cell disease children living in Cameroon

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