Beyond Emergencies: A Five-Year Clinical Profile on the Pattern of Presentation and Seasonal Trend of Out-Patient Visits among Children with Sickle Cell Anaemia.

ABSTRACT

Background: Sickle cell anaemia (SCA) is a common haemoglobinopathy that disproportionately affects children from resource-challenged nations.  Objective: To determine the outcomes of SCA children during outpatient visits and evaluate the impact of the local weather on the incidences of the disease outcomes.  Material and Methods: A five-year retrospective review of clinical encounters among confirmed SCA children with complaints in an outpatient facility of a tertiary hospital in South-East Nigeria. The main outcome measures included vaso-occlusive crises (VOC), respiratory illnesses, and infectious diseases. Analysis was done by Statistical Package for the Social Sciences software version 21 and R ggplot2 package.  Result: The clinical details of 516 outpatient visits among 186 children with SCA were collated. The most prevalent complaint was VOC (33.9%) followed by respiratory illnesses (22.7%) and infectious diseases (10.5%). Patients aged 5-10 years had the highest disease burden (39.3%), with the least burden observed among older adolescents (14.7%). The incidence rate of VOC occurred more during the rainy season with twin peaks in March and July, while respiratory illnesses occurred more during February (dry season). Compared to under-five, children aged 5-10 years and 11-15 years had an increased odds of developing VOC (OR 1.746 CI: 1.006-3.031 and OR: 2.095 CI: 1.168-3.758 respectively) while adolescents aged 11-15 years and above 15 years had a decreased odds of presenting with respiratory illnesses (OR 0.233 CI: 0.120-4.52; OR 0.174 CI: 0.072-0.420 respectively). Conclusion: VOC constitutes the most prevalent complaint during outpatient visits among children with SCA with predilection in the rainy season