Phenotype and Epidemiological Profile of Children with Sickle Cell Disease Followed-Up at the Mother and Child Hospital of N’Djamena

Abstract

In Africa, sickle cell disease is still a public health issue. In Chad, a high prevalence area, it may represent a silent disease. To study the quality of care provided to children with sickle cell disease within the framework of a hospital initiative launched in 2011 and in the absence of a national program in Chad, we conducted this research in the pediatric sickle cell disease center of the Mother and Child Hospital of N’Djamena. This was a cross-sectional study, involving 364 children with sickle cell disease out of 12,500 children followed up from May 2011 to December 2014 (3.9%). The sex ratio was 1.3. The average age at diagnosis was 17 months, often in the context of vaso-occlusive crisis (34.6%). The follow-up protocol included monthly appointments following diagnosis of disease. We observed 80% non-compliance among cases; characteristics associated with non-compliance included families with several children, inaccessible anti-pneumococcal prophylaxis based on Penicillin V and very low anti-pneumococcal vaccine coverage (4.4%). These results suggest that there is a need to rapidly implement a national sickle cell disease program including preventive and curative care in Chad.