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dc.contributor.authorChimbatata, Chikondi Sharon
dc.contributor.authorChisale, Master Ro
dc.contributor.authorKayira, Alfred Bornwell
dc.contributor.authorSinyiza, Frank Watson
dc.contributor.authorMbakaya, Balwani Chingatichifwe
dc.contributor.authorKaseka, Paul Uchizi
dc.contributor.authorKamudumuli, Pocha
dc.contributor.authorWu, Tsung-Shu Joseph
dc.date.accessioned2021-09-30T13:06:09Z
dc.date.available2021-09-30T13:06:09Z
dc.date.issued2021-09-08
dc.identifier.urihttp://hdl.handle.net/10713/16742
dc.description.abstractIntroduction: Sickle cell disease (SCD) remains a major cause of childhood mortality and morbidity in Malawi. However, literature to comprehensively describe the disease in the paediatric population is lacking. Methods: A retrospective review of clinical files of children with SCD was conducted. Descriptive statistics were performed to summarise the data. χ2 or Fisher’s exact test was used to look for significant associations between predictor variables and outcome variables (case fatality and length of hospital stay). Predictor variables that were significantly associated with outcome variables (p≤0.05) in a χ2 or Fisher’s exact test were carried forward for analysis in a binary logistic regression. A multivariable binary logistic regression was used to identify covariates that independently predicted length of hospital stay. Results: There were 16 333 paediatric hospitalisations during the study period. Of these, 512 were patients with SCD representing 3.1% (95% CI: 2.9%- 3.4%). Sixty-eight of the 512 children (13.3%; 95% CI: 10.5% - 16.5%) were newly diagnosed cases. Of these, only 13.2% (95% CI: 6.2% - 23.6%) were diagnosed in infancy. Anaemia (94.1%), sepsis (79.5%) and painful crisis (54.3%) were the most recorded clinical features. The mean values of haematological parameters were as follows: haemoglobin (g/dL) 6.4 (SD=1.9), platelets (×109/L) 358.8 (SD=200.9) while median value for white cell count (×109/L) was 23.5 (IQR: 18.0–31.2). Case fatality was 1.4% (95% CI: 0.6% - 2.8%)and 15.2% (95% CI: 12.2% -18.6%) of the children had a prolonged hospital stay (>5 days). Patients with painful crisis were 1.7 (95% CI: 1.02 - 2.86) times more likely to have prolonged hospital stay than those without the complication. Conclusion: Anaemia, sepsis and painful crisis were the most common clinical features paediatric patients with SCD presented with. Patients with painful crisis were more likely to have prolonged hospital stay. Delayed diagnosis of SCD is a problem that needs immediate attention in this setting. Although somewhat encouraging, the relatively low in-hospital mortality among SCD children may under-report the true mortality from the disease considering community deaths and deaths occurring before SCD diagnosis is made.en_US
dc.description.urihttps://doi.org/10.1136/bmjpo-2021-001097en_US
dc.language.isoenen_US
dc.publisherBMJ Publishing Groupen_US
dc.relation.ispartofBMJ Paediatrics Openen_US
dc.rights© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.en_US
dc.subjecthealth services researchen_US
dc.subjectnursingen_US
dc.subjectpalliative careen_US
dc.titlePaediatric sickle cell disease at a tertiary hospital in Malawi: a retrospective cross-sectional studyen_US
dc.typeArticleen_US
dc.identifier.doi10.1136/bmjpo-2021-001097
dc.identifier.pmid34568588
dc.source.volume5
dc.source.issue1
dc.source.beginpagee001097
dc.source.endpage
dc.source.countryEngland


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