Uchenna C Nnajekwu, Chukwubike O Nnajekwu, Vivian O Onukwuli, Bartholomew F Chukwu, Anthony N Ikefuna, Ifeoma J Emodi
{"title":"尼日利亚埃努古一家三级医院在稳定状态和危机状态下补充叶酸的镰状细胞性贫血儿童叶酸水平:一项前瞻性比较研究。","authors":"Uchenna C Nnajekwu, Chukwubike O Nnajekwu, Vivian O Onukwuli, Bartholomew F Chukwu, Anthony N Ikefuna, Ifeoma J Emodi","doi":"10.4314/mmj.v34i2.9","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>Folic acid supplementation is an integral aspect of the management of children with sickle cell anaemia (SCA) especially in Africa. In spite of this, there have been concerns about lower folate levels, especially during crisis.</p><p><strong>Aim: </strong>To determine red cell folate levels of children with sickle cell anaemia in steady state and during crisis and compare with those with haemoglobin AA genotype.</p><p><strong>Method: </strong>This study was prospective, hospital based, and comparative. Fifty children with sickle cell anaemia were recruited during crises and followed up until they met the criteria for attaining steady state. The controls were fifty children matched with those with SCA for age and gender and had haemoglobin AA genotype. Red cell folate estimation was done with the Electrochemiluminescence Immunoassay (ECLIA) method using the automated Roche Cobas e411 equipment.</p><p><strong>Results: </strong>The median (IQR) red cell folate level in children during sickle cell crisis was 265.95 (134.50) ng/ml, which was significantly lower than the median (IQR) of 376.30 (206.85) ng/ml obtained during steady state. Most children with SCA (41 out of 50) had significantly higher folate levels during steady state (T=1081, Z-score= -4.660, p < 0.001). Median level of red cell folate was lower during anaemic crisis compared to vaso-occlusive crisis, though not significantly so (N(50), U = 214.00, Z-score= -1.077, p = 0.305). The median red cell folate level of normal controls was 343.55 (92.90) ng/ml, which was significantly lower than the 376.30 (206.85) ng/ml obtained during steady state (N(50), U= 209.00, Z-score= -7.177, p <0.001).</p><p><strong>Conclusion: </strong>Median red cell folate levels of the study participants were within normal limits, though most children with SCA had significantly higher levels during steady state compared to crisis. Normal controls had significantly lower red cell folate levels than the children with SCA during steady state.</p>","PeriodicalId":18185,"journal":{"name":"Malawi Medical Journal","volume":" ","pages":"132-137"},"PeriodicalIF":0.8000,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/fb/25/MMJ3402-0132.PMC9356529.pdf","citationCount":"3","resultStr":"{\"title\":\"Folate levels in children with sickle cell anaemia on folic acid supplementation in steady state and crises at a tertiary hospital in Enugu, Nigeria: a prospective, comparative study.\",\"authors\":\"Uchenna C Nnajekwu, Chukwubike O Nnajekwu, Vivian O Onukwuli, Bartholomew F Chukwu, Anthony N Ikefuna, Ifeoma J Emodi\",\"doi\":\"10.4314/mmj.v34i2.9\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>Folic acid supplementation is an integral aspect of the management of children with sickle cell anaemia (SCA) especially in Africa. In spite of this, there have been concerns about lower folate levels, especially during crisis.</p><p><strong>Aim: </strong>To determine red cell folate levels of children with sickle cell anaemia in steady state and during crisis and compare with those with haemoglobin AA genotype.</p><p><strong>Method: </strong>This study was prospective, hospital based, and comparative. Fifty children with sickle cell anaemia were recruited during crises and followed up until they met the criteria for attaining steady state. The controls were fifty children matched with those with SCA for age and gender and had haemoglobin AA genotype. 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The median red cell folate level of normal controls was 343.55 (92.90) ng/ml, which was significantly lower than the 376.30 (206.85) ng/ml obtained during steady state (N(50), U= 209.00, Z-score= -7.177, p <0.001).</p><p><strong>Conclusion: </strong>Median red cell folate levels of the study participants were within normal limits, though most children with SCA had significantly higher levels during steady state compared to crisis. 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引用次数: 3
摘要
叶酸补充是镰状细胞性贫血(SCA)儿童管理的一个组成部分，特别是在非洲。尽管如此，人们还是担心叶酸水平会降低，尤其是在危机期间。目的:测定镰状细胞贫血儿童在稳定状态和危机期的红细胞叶酸水平，并与血红蛋白AA基因型儿童进行比较。方法:本研究为前瞻性、医院性、比较性研究。在危机期间招募了50名患有镰状细胞性贫血的儿童，并对他们进行随访，直到他们达到达到稳定状态的标准。对照组为50名儿童，年龄和性别与SCA患者相匹配，并具有血红蛋白AA基因型。使用罗氏Cobas e411自动化设备，用电化学发光免疫分析法(ECLIA)估算红细胞叶酸。结果:镰状细胞危重期儿童红细胞叶酸水平中位数(IQR)为265.95 (134.50)ng/ml，显著低于稳态时的中位数(IQR) 376.30 (206.85) ng/ml。大多数SCA患儿(50人中有41人)在稳定状态下叶酸水平显著较高(T=1081, Z-score= -4.660, p < 0.001)。红细胞叶酸中位数水平在贫血危相期低于血管闭塞危相期，但差异无统计学意义(N(50)， U = 214.00, Z-score= -1.077, p = 0.305)。正常对照的红细胞叶酸水平中位数为343.55 (92.90)ng/ml，显著低于稳态时的376.30 (206.85)ng/ml (N(50)， U= 209.00, Z-score= -7.177, p)结论:研究参与者的红细胞叶酸水平中位数在正常范围内，但大多数SCA患儿在稳态时的水平明显高于危机时的水平。在稳定状态下，正常对照的红细胞叶酸水平明显低于SCA患儿。
Folate levels in children with sickle cell anaemia on folic acid supplementation in steady state and crises at a tertiary hospital in Enugu, Nigeria: a prospective, comparative study.
Introduction: Folic acid supplementation is an integral aspect of the management of children with sickle cell anaemia (SCA) especially in Africa. In spite of this, there have been concerns about lower folate levels, especially during crisis.
Aim: To determine red cell folate levels of children with sickle cell anaemia in steady state and during crisis and compare with those with haemoglobin AA genotype.
Method: This study was prospective, hospital based, and comparative. Fifty children with sickle cell anaemia were recruited during crises and followed up until they met the criteria for attaining steady state. The controls were fifty children matched with those with SCA for age and gender and had haemoglobin AA genotype. Red cell folate estimation was done with the Electrochemiluminescence Immunoassay (ECLIA) method using the automated Roche Cobas e411 equipment.
Results: The median (IQR) red cell folate level in children during sickle cell crisis was 265.95 (134.50) ng/ml, which was significantly lower than the median (IQR) of 376.30 (206.85) ng/ml obtained during steady state. Most children with SCA (41 out of 50) had significantly higher folate levels during steady state (T=1081, Z-score= -4.660, p < 0.001). Median level of red cell folate was lower during anaemic crisis compared to vaso-occlusive crisis, though not significantly so (N(50), U = 214.00, Z-score= -1.077, p = 0.305). The median red cell folate level of normal controls was 343.55 (92.90) ng/ml, which was significantly lower than the 376.30 (206.85) ng/ml obtained during steady state (N(50), U= 209.00, Z-score= -7.177, p <0.001).
Conclusion: Median red cell folate levels of the study participants were within normal limits, though most children with SCA had significantly higher levels during steady state compared to crisis. Normal controls had significantly lower red cell folate levels than the children with SCA during steady state.
期刊介绍：
Driven and guided by the priorities articulated in the Malawi National Health Research Agenda, the Malawi Medical Journal publishes original research, short reports, case reports, viewpoints, insightful editorials and commentaries that are of high quality, informative and applicable to the Malawian and sub-Saharan Africa regions. Our particular interest is to publish evidence-based research that impacts and informs national health policies and medical practice in Malawi and the broader region.
Topics covered in the journal include, but are not limited to:
- Communicable diseases (HIV and AIDS, Malaria, TB, etc.)
- Non-communicable diseases (Cardiovascular diseases, cancer, diabetes, etc.)
- Sexual and Reproductive Health (Adolescent health, education, pregnancy and abortion, STDs and HIV and AIDS, etc.)
- Mental health
- Environmental health
- Nutrition
- Health systems and health policy (Leadership, ethics, and governance)
- Community systems strengthening research
- Injury, trauma, and surgical disorders
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