Pattern and Severity of Vaso Occlusive Crisis in Paediatric Sickle Cell Anaemia Patient

Aworanti Oladapo
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Abstract

Background: Sickle cell anemia (SCA) remains an inherited disease of public health significance in sub-Saharan Africa with Nigeria accounting for the significant burden of the disease globally. Acute painful crisis/event remains the hallmark of the disease with significant impact on physical and psychosocial wellbeing of both the children and the parents/caregivers despite advancement in care. The pattern and severity of acute painful event/VOC among children living with sickle cell anaemia were evaluated with a view to understand the manifestations of SCA in this group of patients. Methods: This was a prospective cross-sectional study and involved patients who presented at the emergency room, or out-patient unit of the Paediatrics Department of the Lagos University Teaching Hospital, Idi-Araba Lagos with acute painful crisis over a nine-month period (March 2015 - November 2015). Result: The participants was 8±7 years with male to female ratio of 1.1. The distribution of pain with respect to anatomic sites were the extremities extremities and other sites 27 (25.5%), abdomen 13(12.3%) and chest 12(11.3%). Sixty-six (62.3%) children with SCA presented with moderate pain intensity, 30% with severe pain intensity and 4.7% with mild pain intensity. Most of the children presented at the hospital within four days of pain onset. Conclusion : The commonest site of pain among children living with homozygous sickle cell anaemia is in the extremities. Most patients presented within the first four days of onset of pain and with moderate intensity.
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小儿镰状细胞性贫血患者血管闭塞危象的模式和严重程度
背景:镰状细胞性贫血(SCA)仍然是撒哈拉以南非洲具有重大公共卫生意义的遗传性疾病,尼日利亚占全球该疾病的重大负担。急性疼痛危机/事件仍然是该疾病的标志,尽管护理有所进步,但对儿童和父母/照料者的身体和心理健康产生重大影响。评估镰状细胞性贫血儿童急性疼痛事件/VOC的模式和严重程度,以了解该组患者SCA的表现。方法:这是一项前瞻性横断面研究,涉及9个月期间(2015年3月至2015年11月)在拉各斯大学教学医院的急诊室或儿科门诊就诊的急性疼痛危机患者。结果:年龄为8±7岁,男女比例为1.1。疼痛的解剖部位分布为四肢及其他部位27例(25.5%),腹部13例(12.3%),胸部12例(11.3%)。66例(62.3%)SCA患儿表现为中度疼痛强度,30%为重度疼痛强度,4.7%为轻度疼痛强度。大多数患儿在疼痛发作后4天内就诊。结论:纯合子镰状细胞贫血患儿最常见的疼痛部位是四肢。大多数患者在疼痛发作的前四天内出现,疼痛强度中等。
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