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. 2017 Apr 6;12(4):e0175260.
doi: 10.1371/journal.pone.0175260. eCollection 2017.

Socio-environmental exposures and health outcomes among persons with sickle cell disease

Monika R Asnani  1 , Jennifer Knight Madden  1 , Marvin Reid  2 , Lisa-Gaye Greene  3 , Parris Lyew-Ayee  3
Affiliations

Socio-environmental exposures and health outcomes among persons with sickle cell disease

Monika R Asnani et al. PLoS One. .

Abstract

There is much variability in the expression of sickle cell disease (SCD) and recent works suggest that environmental and social factors may also influence this variability. This paper aims to use geographic information systems technology to examine the association between socio-environmental exposures and health outcomes in all persons who have attended or currently attend the Sickle Cell Unit in Jamaica. Rural patients presented for clinical care at older ages and had less annual visits to clinic. Persons travelled relatively long distances to seek SCD care and those travelling longer had less health maintenance visits. Urban patients had a higher prevalence of significant pain crises (69.4% vs. 55.8%, p value<0.001) and respiratory events (21.2% vs. 14%, p value<0.001). Prevalence of leg ulcers did not vary between rural and urban patients but was higher in males than in females. Females also had lower odds of having respiratory events but there was no sex difference in history of painful crises. Persons with more severe genotypes lived in higher poverty and travelled longer for healthcare services. Persons in areas with higher annual rainfall, higher mean temperatures and living farther from factories had less painful crises and respiratory events. The paper highlights a need for better access to healthcare services for Jamaicans with SCD especially in rural areas of the island. It also reports interesting associations between environmental climatic exposures and health outcomes.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Distance from a sickle cell clinic in kilometres.
Fig 2
Fig 2. Elevation above sea level in metres.
Fig 3
Fig 3. Rainfall in millimetres, mean of 30 years.
See this image and copyright information in PMC

References

    1. Asnani MR (2010) Sickle cell disease In: Stone JH, Blouin M, editors. International encyclopedia of rehabilitation: Center for International Rehabilitation Research Information and Exchange;. pp. 1–20.
    1. Serjeant GR, Serjeant BE, Forbes M, Hayes RJ, Higgs DR, et al. (1986) Haemoglobin gene frequencies in the Jamaican population: a study in 100,000 newborns. Br J Haematol 64: 253–262. - PubMed
    1. Poillon WN, Kim BC, Castro O (1998) Intracellular hemoglobin S polymerization and the clinical severity of sickle cell anemia. Blood 91: 1777–1783. - PubMed
    1. Meshikhes AW, al-Faraj AA (1998) Sickle cell disease and the general surgeon. J R Coll Surg Edinb 43: 73–79. - PubMed
    1. Jones S, Duncan ER, Thomas N, Walters J, Dick MC, et al. (2005) Windy weather and low humidity are associated with an increased number of hospital admissions for acute pain and sickle cell disease in an urban environment with a maritime temperate climate. Br J Haematol 131: 530–533. doi: 10.1111/j.1365-2141.2005.05799.x - DOI - PubMed