Skip to content
Home
About Us
Resources
Profiles Metrics
Authors Directory
Institutions Directory
Top Authors
Top Institutions
Top Sponsors
AI Digest
Contact Us
Menu
Home
About Us
Resources
Profiles Metrics
Authors Directory
Institutions Directory
Top Authors
Top Institutions
Top Sponsors
AI Digest
Contact Us
Home
About Us
Resources
Profiles Metrics
Authors Directory
Institutions Directory
Top Authors
Top Institutions
Top Sponsors
AI Digest
Contact Us
Menu
Home
About Us
Resources
Profiles Metrics
Authors Directory
Institutions Directory
Top Authors
Top Institutions
Top Sponsors
AI Digest
Contact Us
Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
Mortality in sickle cell anemia in africa: A prospective cohort study in Tanzania
PLoS ONE, Volume 6, No. 2, Article e14699, Year 2011
Notification
URL copied to clipboard!
Description
Background:The World Health Organization has declared Sickle Cell Anemia (SCA) a public health priority. There are 300,000 births/year, over 75% in Africa, with estimates suggesting that 6 million Africans will be living with SCA if average survival reaches half the African norm. Countries such as United States of America and United Kingdom have reduced SCA mortality from 3 to 0.13 per 100 person years of observation (PYO), with interventions such as newborn screening, prevention of infections and comprehensive care, but implementation of interventions in African countries has been hindered by lack of locally appropriate information. The objective of this study was to determine the incidence and factors associated with death from SCA in Dar-es-Salaam.Methods and Findings:A hospital-based cohort study was conducted, with prospective surveillance of 1,725 SCA patients recruited from 2004 to 2009, with 209 (12%) lost to follow up, while 86 died. The mortality rate was 1.9 (95%CI 1.5, 2.9) per 100 PYO, highest under 5-years old [7.3 (4.8-11.0)], adjusting for dates of birth and study enrollment. Independent risk factors, at enrollment to the cohort, predicting death were low hemoglobin (<5 g/dL) [3.8 (1.8-8.2); p = 0.001] and high total bilirubin (≥102 μmol/L) [1.7 (1.0-2.9); p = 0.044] as determined by logistic regression.Conclusions:Mortality in SCA in Africa is high, with the most vulnerable period being under 5-years old. This is most likely an underestimate, as this was a hospital cohort and may not have captured SCA individuals with severe disease who died in early childhood, those with mild disease who are undiagnosed or do not utilize services at health facilities. Prompt and effective treatment for anemia in SCA is recommended as it is likely to improve survival. Further research is required to determine the etiology, pathophysiology and the most appropriate strategies for management of anemia in SCA. © 2011 Makani et al.
Authors & Co-Authors
Makani, Julie B.
Tanzania, Dar es Salaam
Muhimbili University of Health and Allied Sciences
United Kingdom, Oxford
Nuffield Department of Medicine
Cox, Sharon E.
Tanzania, Dar es Salaam
Muhimbili University of Health and Allied Sciences
United Kingdom, London
Medical Research Council
Soka, Deogratias
Tanzania, Dar es Salaam
Muhimbili University of Health and Allied Sciences
Komba, Albert N.
Tanzania, Dar es Salaam
Muhimbili University of Health and Allied Sciences
Oruo, Julie
Tanzania, Dar es Salaam
Muhimbili University of Health and Allied Sciences
Mwamtemi, Hadija
Tanzania, Dar es Salaam
Muhimbili University of Health and Allied Sciences
Magesa, Pius M.
Tanzania, Dar es Salaam
Muhimbili University of Health and Allied Sciences
Rwezaula, Stella
Tanzania, Dar es Salaam
Muhimbili University of Health and Allied Sciences
Meda, Elineema
Tanzania, Dar es Salaam
Muhimbili University of Health and Allied Sciences
Mgaya, Josephine A.
Tanzania, Dar es Salaam
Muhimbili University of Health and Allied Sciences
Lowe, Brett S.
United Kingdom, Oxford
Nuffield Department of Medicine
Kenya, Kilifi
Centre for Geographic Medicine Research
Muturi, David
Kenya, Kilifi
Centre for Geographic Medicine Research
Roberts, David J.
United Kingdom, Oxford
Nuffield Department of Medicine
United Kingdom, Bristol
Nhs Blood and Transplant
Williams, Thomas Neil
United Kingdom, Oxford
Nuffield Department of Medicine
Kenya, Kilifi
Centre for Geographic Medicine Research
Ghana, Accra
Indepth Network
Pallangyo, Kisali J.
Tanzania, Dar es Salaam
Muhimbili University of Health and Allied Sciences
Kitundu, Jesse A.
Tanzania, Dar es Salaam
Muhimbili University of Health and Allied Sciences
Fegan, Greg
United Kingdom, London
Medical Research Council
Kenya, Kilifi
Centre for Geographic Medicine Research
Kirkham, Fenella Jane
United Kingdom, London
Ucl Great Ormond Street Institute of Child Health
Marsh, Kevin
United Kingdom, Oxford
Nuffield Department of Medicine
Kenya, Kilifi
Centre for Geographic Medicine Research
Newton, Charles R.J.C.
Tanzania, Dar es Salaam
Muhimbili University of Health and Allied Sciences
United Kingdom, London
Medical Research Council
Kenya, Kilifi
Centre for Geographic Medicine Research
United Kingdom, London
Ucl Great Ormond Street Institute of Child Health
Statistics
Citations: 271
Authors: 20
Affiliations: 7
Identifiers
Doi:
10.1371/journal.pone.0014699
e-ISSN:
19326203
Research Areas
Health System And Policy
Maternal And Child Health
Study Design
Cohort Study
Study Approach
Quantitative
Study Locations
Tanzania