Hospital Prevalence of Sickle Cell Disease in Children Under 5 Years of Age in a Region of the Democratic Republic of Congo

Abstract

Backgroung: The burden of sickle cell disease in hospitals is less described in both children and adults where there is a lack of universal screening programs. This is more observed in low-income countries and compromises the life expectancy of people with unrecognized major sickle cell disease. The objective of this study was to estimate the more or less concrete burden of sickle cell disease in pediatric hospitals, mainly in children under 5 years of age. Materials & methods: To do this, a cross-sectional and descriptive survey was carried out at the level of the pediatric services of 5 health facilities of the City of Kindu, capital of the province of Maniema in the Democratic Republic of the Congo from December 2, 2019 to October 15, 2020, that to say 10 months. It consisted mainly in the systematic screening of the electrophoretic profile of children under 5 admitted to the said health facilities using a rapid test. Results: The analyzes showed that the hospital prevalence of major sickle cell disease was 12.7%. The mean age of children with major sickle cell anemia was 41 ± 18 months. The median age was 48 months with the extreme ages 2 and 59 months. The 48 to 59 months age group was represented with 56.1% of children with SS sickle cell disease. The prevalence of sickle cell status was significantly associated with age group (p <0.0001). The sex ratio M/F was 1.1. The sickle cell status was independent of the sex of the child. Conclusion: The findings of this study show that the burden of sickle cell disease in pediatric hospitals and mainly in children under 5 years of age is underestimated in the absence of systematic screening. Faced with the delay in the implementation of universal screening in Africa, systematic hospital screening of all children and mainly those under 5 years of age using rapid tests will improve diagnosis and life expectancy of patients with major sickle cell anaemia.