Preprint Article Version 3 Preserved in Portico This version is not peer-reviewed

Improvement of Sickle Cell Disease Morbimortality in Children: Experience in a Remote Area of an African Country

Version 1 : Received: 18 May 2020 / Approved: 18 May 2020 / Online: 18 May 2020 (17:26:04 CEST)
Version 2 : Received: 20 September 2020 / Approved: 22 September 2020 / Online: 22 September 2020 (08:12:05 CEST)
Version 3 : Received: 10 October 2020 / Approved: 12 October 2020 / Online: 12 October 2020 (15:14:46 CEST)

How to cite: Mbiya, B.M.; Kalombo, D.K.; Mukendi, Y.N.; Daubie, V.; Mpoyi, J.K.; Biboyi, P.M.; Disashi, G.T.; Gulbis, B. Improvement of Sickle Cell Disease Morbimortality in Children: Experience in a Remote Area of an African Country. Preprints 2020, 2020050305 (doi: 10.20944/preprints202005.0305.v3). Mbiya, B.M.; Kalombo, D.K.; Mukendi, Y.N.; Daubie, V.; Mpoyi, J.K.; Biboyi, P.M.; Disashi, G.T.; Gulbis, B. Improvement of Sickle Cell Disease Morbimortality in Children: Experience in a Remote Area of an African Country. Preprints 2020, 2020050305 (doi: 10.20944/preprints202005.0305.v3).

Abstract

Background: Sickle cell disease (SCD) is a public health problem in the Democratic Republic of Congo. While reference sickle cell centers have been implemented in capital cities of African countries and have proven to be beneficial for SCD patients, they have never been set up in rural areas for families with very low sources of income. Method: A cohort of 143 children with SCD aged 10 years old (IQR (interquartile range): 6–15 years) (sex ratio male/female = 1.3) were clinically followed for 12 months without any specific intervention aside from the management of acute events, and then for 12 months with a monthly medical visit, biological follow-up, and regular prophylaxis. Results: The median age of patients at the diagnosis of SCD was 2 years (IQR: 1–5). The implementation of standardized and regular follow-ups in a new sickle cell referral center in a remote city showed an increase in the annual mean hemoglobin level from 50 to 70 g/L (p = 0.001), and a decrease in the lymphocyte count and spleen size (p < 0.001). A significant decrease (p < 0.001) in the average annual number of hospitalizations and episodes of vaso-occlusive crises, blood transfusions, infections, and acute chest syndromes were also observed. Conclusions: Creation of a sickle cell referral center and the regular follow-up of children with SCD are possible and applicable in the context of a remote city of an African country and represent simple and accessible measures that can reduce the morbimortality of children with sickle cell disease.

Subject Areas

sickle cell disease; feasibility; regular follow-up; remote area; Democratic Republic of Congo

Comments (1)

Comment 1
Received: 12 October 2020
Commenter: Benoît Mukinayi MBIYA
Commenter's Conflict of Interests: Author
Comment: The article has been revised and improved with the help of several online reviewers. We thank everyone who contributed for the improvement of this article. it is currently submitted in BHSR
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