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

 

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dc.contributor.author Sawe, Hendry R
dc.contributor.author Reynolds, Teri A
dc.contributor.author Mfinanga, Juma A
dc.contributor.author Runyon, Michael S
dc.contributor.author Murray, Brittany L
dc.contributor.author Wallis, Lee A
dc.contributor.author Makani, Julie
dc.date.accessioned 2018-09-25T11:15:48Z
dc.date.available 2018-09-25T11:15:48Z
dc.date.issued 2018-09-17
dc.identifier.citation Sawe, H. R., Reynolds, T. A., Mfinanga, J. A., Runyon, M. S., Murray, B. L., Wallis, L. A., & Makani, J. (2018). The clinical presentation, utilization, and outcome of individuals with sickle cell anaemia presenting to urban emergency department of a tertiary hospital in Tanzania. BMC Hematology, 18(1), 25.
dc.identifier.uri https://doi.org/10.1186/s12878-018-0122-3
dc.identifier.uri http://hdl.handle.net/11427/28491
dc.description.abstract Background 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. Methods 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. Results 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 (p < 0.0001) respectively, compared to patients with normal vitals. Overall, 656 (87.2%) patients received Complete Blood Cell counts test, of these 342 (52.1%) had severe anaemia (haemoglobin < 7 g/dl), and a 30.3 (p = 0.02) relative risk of relative risk of mortality compare to patients with higher haemoglobin. Patients who had malaria, elevated renal function test and hypoglycemia, had relative risk of mortality of 22.9, 10.4 and 45.2 (p < 0.0001) respectively, compared to patient with normal values. Most 534 (71.0%) patients were hospitalized for in patients care, and the overall morality rate was 16 (2.1%). Conclusions We described the clinical presentation, management, and outcomes of patients with SCA presenting to the largest public ED in Tanzania, as well as information on resource utilization. This information can inform development of treatment guidelines, clinical staff education, and clinical research aimed at optimizing care for SCA patients.
dc.language.iso en
dc.publisher BioMed Central
dc.source BMC Hematology
dc.source.uri https://bmchematol.biomedcentral.com/
dc.subject.other Sickle cell anaemia
dc.subject.other Emergency department
dc.subject.other Anaemia
dc.subject.other Sub-Saharan Africa
dc.title The clinical presentation, utilization, and outcome of individuals with sickle cell anaemia presenting to urban emergency department of a tertiary hospital in Tanzania
dc.type Journal Article
dc.date.updated 2018-09-23T03:32:01Z
dc.rights.holder The Author(s).
dc.publisher.institution University of Cape Town
dc.publisher.faculty Faculty of Health Sciences en_ZA
dc.publisher.department Division of Dermatology en_ZA
uct.type.filetype Text
uct.type.filetype Image


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