American Journal of Clinical Medicine Research
ISSN (Print): 2328-4005 ISSN (Online): 2328-403X Website: https://www.sciepub.com/journal/ajcmr Editor-in-chief: Dario Galante
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American Journal of Clinical Medicine Research. 2025, 13(2), 18-23
DOI: 10.12691/ajcmr-13-2-1
Open AccessArticle

Clinical Profile, Management Patterns, and Outcomes of Sickle Cell Disease at a Tertiary Hospital in Nigeria

Bola. F Akinkunmi1, 2, , Caroline O. Odunlade1, 2, Afe D1, 2 and Olugbemiga O. Adeodu1, 2

1Department of Paediatrics and Child Health University of Medical Sciences Ondo, Nigeria

2Deparment of Paediatrics University of Medical Sciences Teaching Hospital Ondo, Nigeria

Pub. Date: April 20, 2025

Cite this paper:
Bola. F Akinkunmi, Caroline O. Odunlade, Afe D and Olugbemiga O. Adeodu. Clinical Profile, Management Patterns, and Outcomes of Sickle Cell Disease at a Tertiary Hospital in Nigeria. American Journal of Clinical Medicine Research. 2025; 13(2):18-23. doi: 10.12691/ajcmr-13-2-1

Abstract

Sickle cell disease (SCD) is a major public health concern in Nigeria, with a high prevalence and significant morbidity and mortality. Despite advances in management strategies, gaps in comprehensive care persist, particularly in resource-limited settings. This study aims to assess the clinical profile, management patterns, and outcomes of SCD patients at a tertiary hospital in Nigeria. A retrospective hospital-based audit was conducted at the University of Medical Sciences Teaching Hospital Complex, Ondo, Nigeria. Medical records of patients diagnosed with SCD were reviewed. Data collected included demographic characteristics, clinical presentations, frequency and types of crises, management strategies, and treatment outcomes. Descriptive and inferential statistical analyses were performed to identify predictors of adverse outcomes. A total of 71 patients were included in the study, with a mean age of 6.8 ± 3.8 years. Vaso-occlusive crises were the most common complication occurring in 74.6% of patients, followed by hemolytic (14.1%), sequestration (4.2%), aplastic (1.4%), and megaloblastic (2.8%) crises. None of the patients received hydroxyurea therapy, while folic acid (97.2%) and antimalarial prophylaxis (95.8%) were the most used medications. The mean number of blood transfusions per year was 1.2 (IQR: 1.0–2.0), and specialist consultations were infrequent. Logistic regression analysis identified lower lowest recorded packed cell volume (PCV) as a significant predictor of adverse outcomes (OR: 0.488, 95% CI: 0.286–0.835, p = 0.009). The findings highlight critical gaps in SCD management, including the underutilization of hydroxyurea and limited access to specialist care. Addressing these gaps through policy initiatives, provider education, and healthcare system strengthening could improve patient outcomes. These results provide valuable insights for optimizing SCD management in Nigeria.

Keywords:
sickle cell disease vaso-occlusive crisis management Nigeria hydroxyurea blood transfusion outcomes

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References:

[1]  Rees DC, Williams TN, Gladwin MT. Sickle-cell disease. Lancet. 2010; 376(9757): 2018-31.
 
[2]  World Health Organization. Sickle-cell disease: A strategy for the WHO African Region. WHO Report. 2023.
 
[3]  Adewoyin AS. Management of sickle cell disease: A review for physician education in Nigeria (sub-Saharan Africa). Anemia. 2015; 2015: 791498.
 
[4]  Yawn BP, Buchanan GR, Afenyi-Annan AN, Ballas SK, Hassell KL, James AH, et al. Management of sickle cell disease: Summary of the 2014 evidence-based report by expert panel members. JAMA. 2014; 312(10): 1033-48.
 
[5]  U.S. Food and Drug Administration. FDA approves first gene therapies for sickle cell disease. FDA Report. 2023.
 
[6]  Kadam P, Bhalerao S. Sample size calculation. Int J Ayurveda Res. 2010; 1(1): 55-7.
 
[7]  Charache S, Terrin ML, Moore RD, Dover GJ, Barton FB, Eckert SV, et al. Effect of hydroxyurea on the frequency of painful crises in sickle cell anemia. N Engl J Med. 1995; 332(20): 1317-22.
 
[8]  World Health Organization. Sickle-cell disease: A strategy for the WHO African Region. WHO Report. 2011.
 
[9]  Howard J, Hart N, Roberts-Harewood M, Cummins M, Awogbade M, Davis B. Guideline on the management of acute and chronic sickle cell disease: A British Society for Haematology guideline. Br J Haematol. 2013; 160(6): 759-90.
 
[10]  DeBaun MR, Armstrong FD, McKinstry RC, Ware RE, Vichinsky E. Silent cerebral infarcts: A review on a prevalent and progressive cause of neurologic injury in sickle cell anemia. Blood. 2012; 119(20): 4587-96.
 
[11]  Quinn CT, Rogers ZR, McCavit TL, Buchanan GR. Improved survival of children and adolescents with sickle cell disease. Blood. 2010; 115(17): 3447-52.
 
[12]  Odièvre MH, Verger E, Silva-Pinto AC, Elion J. Pathophysiological insights in sickle cell disease. Indian J Med Res. 2011; 134(4): 532-7.
 
[13]  Piel FB, Patil AP, Howes RE, Nyangiri OA, Gething PW, Dewi M, et al. Global epidemiology of sickle haemoglobin in neonates: a contemporary geostatistical model-based map and population estimates. Lancet. 2013; 381(9861): 142-51.
 
[14]  Kanter J, Krishnamurti L. Advances in the management of sickle cell disease. Pediatr Clin North Am. 2020; 67(5): 919-28.Fogg, B.J, Persuasive technology: using computers to change what we think and do, Morgan Kaufmann Publishers, Boston, 2003, 30-35.