Tuberculosis in children with sickle cell anaemia: a retrospective study in French tertiary care centres

Droz, Nina; Lauzanne, Agathe de; Holvoet, Laurent; Missud, Florence; Benkerrou, Malika; Brousse, Valentine; Odièvre, Marie‐Hélène; Faye, Albert; Koehl, Bérengère

doi:10.1007/s00431-017-2905-0

Cited by 7 publications

(3 citation statements)

References 17 publications

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“…M. tuberculosis and SCD are prevalent co-morbidities in austere environments, and features of tuberculosis in children with SCD are comparable to those in the general population with favorable outcomes with standard treatment (111).…”

Section: Mycobacteriamentioning

confidence: 96%

Life-Threatening Infectious Complications in Sickle Cell Disease: A Concise Narrative Review

et al. 2020

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Sickle cell disease (SCD) results in chronic hemolytic anemia, recurrent vascular occlusion, insidious vital organ deterioration, early mortality, and diminished quality of life. Life-threatening acute physiologic crises may occur on a background of progressive diminishing vital organ function. Sickle hemoglobin polymerizes in the deoxygenated state, resulting in erythrocyte membrane deformation, vascular occlusion, and hemolysis. Vascular occlusion and increased blood viscosity results in functional asplenia and immune deficiency in early childhood, resulting in life-long increased susceptibility to serious bacterial infections. Infection remains a main cause of overall mortality in patients with SCD in low-and middle-income countries due to increased exposure to pathogens, increased co-morbidities such as malnutrition, lower vaccination rates, and diminished access to definitive care, including antibiotics and blood. Thus, the greatest gains in preventing infection-associated mortality can be achieved by addressing these factors for SCD patients in austere environments. In contrast, in high-income countries, perinatal diagnosis of SCD, antimicrobial prophylaxis, vaccination, aggressive use of antibiotics for febrile episodes, and the availability of contemporary critical care resources have resulted in a significant reduction in deaths from infection; however, chronic organ injury is problematic. All clinicians, regardless of their discipline, who assume the care of SCD patients must understand the importance of infectious disease as a contributor to death and disability. In this concise narrative review, we summarize the data that describes the importance of infectious diseases as a contributor to death and disability in SCD and discuss pathophysiology, prevalent organisms, prevention, management of acute episodes of critical illness, and ongoing care.

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Section: Mycobacteriamentioning

confidence: 96%

Life-Threatening Infectious Complications in Sickle Cell Disease: A Concise Narrative Review

et al. 2020

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“…The burden of TB in this country seems to be exacerbated by the difficult socio-economic situation and the high prevalence of some intercurrent infections such as HIV, malaria and non-specific bacterial infections. In addition, Sickle Cell Anemia (SCA), a chronic hemolytic anemia, is particularly highly prevalent in DRC and co-morbidity TB-SCA can be expected in this country as reported elsewhere [2] [3]. Each of these factors often results in anemia among other complications, making the Congolese population one at high risk for anemia of various origins.…”

Section: Introductionmentioning

confidence: 97%

Anemia and Hematologic Characteristics in Newly Diagnosed Pulmonary Tuberculosis Patients at Diagnosis in Kinshasa

Mulenga¹,

Kayembe²,

Kabengele³

et al. 2017

JTR

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Context: The burden of TB in Africa tends to be exacerbated by the socio-economic situation and the high prevalence of intercurrent infections such as HIV, malaria and non-specific bacterial infections. These factors often result in anemia, making patients at high risk for anemia. Objective: We aimed to gain insights into the characteristics of anemia, hematologic variations and socio-economic status in untreated pulmonary TB patients (PTB) in Kinshasa, the Democratic Republic of Congo. Methods: We conducted a cross-sectional analysis of 200 smear-positive pulmonary TB patients (PTB) recruited at the initiation of TB treatment. Complete Blood Count, Iron profile, BMI, CRP and albuminemia were assessed. Data were analyzed using Student t or Mann Whitney tests as appropriate, and logistic regression was performed to assess the strength of associations. Results: Anemia was a regular finding in (69%). This anemia was mostly moderate (92.2%) and with iron deficiency pattern (48%). Hypoalbuminemia was observed in half of the subjects and appears to be correlated with the severity of anemia. Surprisingly, the severity of inflammation, as reflected by the CRP, was inversely correlated with the anemia. In the multivariate analysis, alcohol intake (OR: 2.38; IC 95%: 1.05 -5.38), hypoalbuminemia (OR: 1.98; IC 95%: 1.02 -3.82) and CRP rate were significantly associated with the presence of anemia among pulmonary tuberculosis at the diagnostic. Conclusion: This study demonstrates the heavy burden of the iron responsive anemia and risky life conditions in newly diagnosed TB patients, and underscores the potential usefulness of iron supplementation in the Congolese context.

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“…The main risk factors of NTM in bloodstream infections are indwelling vascular catheters (IDVC), which are known to affect the immune system that causes relative immune deficiencies in SCD [106]. Recently, a Multicenter study suggests that Mycobacterium does not seem to be a risk factor for severe Tuberculosis (TB) and not a risk factor for mortality [107].…”

Section: Mycobacteriamentioning

confidence: 99%

Infection and Potential Challenge of Childhood Mortality in Sickle Cell Disease: A Comprehensive Review of the Literature from a Global Perspective

Sahu,

Pande,

Verma

et al. 2023

Thalassemia Reports

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Sickle cell disease (SCD) is a complex genetic disorder associated with multiple clinical manifestations, including increased susceptibility to bacterial and viral infections. This review article presents a comprehensive analysis of the current literature obtained from various online databases focusing on the relationship between SCD and infections caused by specific pathogens, such as pneumonia- and influenza-causing pathogens, Escherichia coli, Staphylococcus aureus, parvovirus, and hepatitis viruses. We discuss the underlying mechanisms that contribute to the increased susceptibility of individuals with SCD to these infections, primarily related to the pathophysiology of variant hemoglobin (HbSS) and its impact on vascular occlusion, hemolysis, functional asplenia, and immune deficiency. Moreover, we highlight the significant burden of infections on SCD patients, particularly children under five years of age, where they are the leading cause of morbidity and mortality. Additionally, we address the challenges faced in attempts for reducing the global mortality rate associated with SCD, particularly in low-income countries, where factors such as increased pathogen exposure, co-morbidities like malnutrition, lower vaccination rates, and limited healthcare facilities contribute to the high disease burden. This review emphasizes the need for targeted interventions, improved healthcare access, vaccination programs, and infection prevention strategies to alleviate the impact of infections on individuals with SCD and reduce the global mortality rates associated with the disease.

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Tuberculosis in children with sickle cell anaemia: a retrospective study in French tertiary care centres

Cited by 7 publications

References 17 publications

Life-Threatening Infectious Complications in Sickle Cell Disease: A Concise Narrative Review

Life-Threatening Infectious Complications in Sickle Cell Disease: A Concise Narrative Review

Anemia and Hematologic Characteristics in Newly Diagnosed Pulmonary Tuberculosis Patients at Diagnosis in Kinshasa

Infection and Potential Challenge of Childhood Mortality in Sickle Cell Disease: A Comprehensive Review of the Literature from a Global Perspective

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