Factors associated with complications among children and adolescents with sickle cell disease in a tertiary hospital in southwestern Nigeria.

Abstract

Background: Despite Nigeria having the largest burden of sickle cell disease (SCD) globally, the spectrum of complications and associated factors remains an understudied area, with most studies focused on acute complications of vaso-occlusive crisis. Hence, we determined the spectrum of complications (acute and chronic) of sickle cell disease and the associated factors among Nigerian children and adolescents residing in southwestern Nigeria.

Methods: This cross-sectional descriptive study was conducted among children and adolescents with SCD in southwestern Nigeria from January 2021 to June 2022. We obtained relevant information from the caregivers and verified this using case record files and physical examinations to identify past or present evidence of complications.

Results: Among the 100 children and adolescents recruited, 34 (34.0%) had at least one complication of SCD, 21 (61.8%) of whom were males. Osteomyelitis was the most common complication 20 (58.8%)] of 34 patients. The variables associated with complications were age, hospital admissions, total white blood cell count, and liver size. After adjusting for confounders, the variables associated with complications were adolescent age [adjusted odds ratio (AOR) of 7.8, 95% confidence interval (CI)] of 1.806-33.225, hepatomegaly of 2.0-5.0 cm with an AOR of 4.8 (95% CI of 1.199-18.782), and hepatomegaly greater than 5.0 cm with an AOR of 8.8 (95% CI of 1.989-38.676).

Conclusion: This study revealed that one-third of SCD children and adolescents experienced at least one complication, and half experienced osteomyelitis. Being an adolescent and the presence of hepatomegaly increased the odds of complications of SCD.