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Year : 2019  |  Volume : 8  |  Issue : 2  |  Page : 53-57

Acute chest syndrome in sickle cell disease patients: Experience from a resource constrained setting

1 Department of Pediatrics, College of Medicine, University of Lagos, Lagos University Teaching Hospital, Lagos, Nigeria
2 Department of Pediatrics, Lagos University Teaching Hospital, Lagos, Nigeria

Correspondence Address:
Dr. Adeseye M Akinsete
Department of Pediatrics, College of Medicine, University of Lagos, Lagos University Teaching Hospital, Lagos
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ijh.ijh_1_19

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BACKGROUND: Sickle cell anemia is the most common inheritable hemoglobin disorder in the world with very high prevalence, morbidity, and mortality in Sub-Saharan Africa. Acute chest syndrome (ACS) is one of the most common causes of mortality among individuals with the condition. The management of this condition involves watchful waiting which may be deleterious in resource-constrained settings. The use of exchange blood transfusion (EBT) has been reported to be beneficial. The use of this great intervention is even further hampered in most of the developing world. The aim of this study was to review the outcome data of children managed with an algorithm adopted in 2015 at a University Teaching Hospital in a resource-constrained setting. MATERIALS AND METHODS: This was a retrospective study from January 2015 to December 2017 at a University Teaching Hospital. Ethical approval was obtained from the Hospital's Health, Research, and Ethics committee. RESULTS: A total of 324 children with sickle cell disease were admitted in the period under review with a male-to-female ratio of 1.5:1. Thirty-three patients were suspected of having ACS, but only 12 were confirmed using the algorithm. The mean age at presentation was 8 years with over 85% of the patients having a triad of fever, cough, and chest pain. All the patients had EBT within 48 h of admission and mortality rate recorded was 16.7%. CONCLUSION: The use of the algorithm as well as the preemptive EBT improved the outcome of the children accessing care at our facility.

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