The clinical presentation, utilization, and outcome of individuals with sickle cell anaemia presenting to urban emergency department of a tertiary hospital in Tanzania

Sickle cell anaemia (SCA) is prevalent in sub-Saharan Africa, with high risk of complications requiring emergency care. There is limited information about presentation of patients with SCA to hospitals for emergency care. We describe the clinical presentation, resource utilization, and outcomes of S...

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Bibliographic Details
Published in:BMC blood disorders 2018-09, Vol.18 (1), p.25-25, Article 25
Main Authors: Sawe, Hendry R, Reynolds, Teri A, Mfinanga, Juma A, Runyon, Michael S, Murray, Brittany L, Wallis, Lee A, Makani, Julie
Format: Article
Language:English
Subjects:
Anemia
Births
Blood
Blood transfusions
Care and treatment
Developing countries
Emergency medical care
Hemoglobin
Hypoglycemia
Industrialized nations
Internet
LDCs
Malaria
Morbidity
Mortality
Pain
Patient outcomes
Sickle cell anemia
Sickle cell disease
Teaching hospitals
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Summary:Sickle cell anaemia (SCA) is prevalent in sub-Saharan Africa, with high risk of complications requiring emergency care. There is limited information about presentation of patients with SCA to hospitals for emergency care. We describe the clinical presentation, resource utilization, and outcomes of SCA patients presenting to the emergency department (ED) at Muhimbili National Hospital (MNH) in Dar es Salaam, Tanzania. This was a prospective cohort study of consecutive patients with SCA presenting to ED between December 2014 and July 2015. Informed consent was obtained from all patients or patients' proxies prior to being enrolled in the study. A standardized case report form was used to record study information, including demographics, relevant clinical characteristics and overall patients outcomes. Categorical variables were compared with chi-square test or Fisher's exact test; continuous variables were compared with two-sample t-test or Mann-Whitney U-test. We enrolled 752 (2.7%) people with SCA from 28,322 patients who presented to the MNH-ED. The median age was 14 years (Interquartile range [IQR]: 6-23 years), and 395 (52.8%) were female. Pain 614 (81.6%), fever 289 (38.4%) were the most frequent presenting complaint. Patients with fever, hypoxia, altered mental status and bradycardia had statistically significant relative risk of mortality of 10.4, 153, 50 and 12.1 (  
ISSN:2052-1839
2052-1839
1471-2326
DOI:10.1186/s12878-018-0122-3