Patterns of illness among children with sickle cell disease accessing care at the Komfo Anokye Teaching Hospital (KATH), Kumasi, Ghana.

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November, 2016
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Children with Sickle Cell Disease (SCD) suffer from several forms of complications. Some chronic, others acute which result in their frequent visits to the hospital. SCD is most prevalent in Sub-Saharan Africa where malaria is very common. Reports from focused studies carried out in Ghana, indicate a carrier rate ranging from 10% to 30% in the population whereas 2% of all new-borns have SCD, with the common genotypes being HbSS and HbSC. Reliable data on the common presentations and accompanying complications presented are lacking. This study was therefore carried out to identify the patterns of Illness presented by children with SCD to the Komfo Anokye Teaching Hospital (KATH). This was a cross-sectional study that involved the use of secondary data from the Sickle Cell Clinic at KATH for a period of three years (2012- 2014). Data from children aged ≤ 14 years with SCD accessing care at the hospital were extracted and analysed on the basis of demographic details, haemoglobin genotype, types of crises, associated infections, diagnosis and number of visits within the period. Stata software version 11 was used to test for associations between demographic factors and development of crises. Altogether 234 children were recruited within the study period. The common crises presented were vaso-occlusive (44%) followed by haemolytic crises (35%). The most common associated infection was malaria (20.8%). The study revealed significant association of age, gender and co-morbidity to the development of SCD crises. Being in the age group 10-14, [AOR= 4.8, 95% CI, 2.16- 10.99: p-value <0.001] and having malaria as an infection, [AOR=4.7, 95% CI, (1.60- 13.86): p-value=0.005], had a statistically significant association with developing pain episode. Male gender was associated with developing haemolytic crisis [AOR=2.3, 95% CI, 1.09 – 4.91: p-value=0.027]. Sickle Cell Disease presents with several complications that may be associated with age, gender and current associated infections. Knowledge of one’s state and prevention of intercurrent illnesses could result in a reduction in complications.
A thesis submitted to the Department of Health Promotion and Education, School of Public Health, College of Health Sciences, Kwame Nkrumah University of Science and Technology, in partial fulfilment of the requirements for the degree of Master of Public Health in Health Promotion and Education.