Homozygous Sickle Cell Disease after Age of 40: Follow-Up of a Cohort of 209 Patients in Senegal, West Africa
- PMID: 38356903
- PMCID: PMC10864044
- DOI: 10.1155/2024/7501577
Homozygous Sickle Cell Disease after Age of 40: Follow-Up of a Cohort of 209 Patients in Senegal, West Africa
Abstract
Objectives: The aim of this study was to describe the morbidity and mortality of homozygous sickle cell disease after the age of 40.
Methods: This was a cohort study of 209 patients followed from 1994 to 2022. All hemoglobin electrophoresis-confirmed SS sickle cell patients over 40 years were included. A descriptive study of epidemiological, diagnostic, therapeutic, and evolutionary data was used to assess morbidity and mortality.
Results: Sex ratio (M/F) was 0.6. Median age was 47 (41-75). According to morbidity, 95.1% had less than 3 vaso-occlusive crises/year. Acute anemia was the most frequent complication (52.63%). Chronic complications were noted in 32.5%. At diagnosis, mean hemoglobin was 8.1 g/dl ± 1.9, HbS was 86.5 ± 10, and HbF was 9.4 ± 7.6. Number of patients transfused was 66%. We noted that 8.1% of patients died, 29.2% were lost to follow-up, and 62.7% were still being followed up. The risk factors identified for death were geographical origin, comorbidity, high HbS, low HbF, and thrombocytosis.
Conclusion: This study shows that homozygous SCD is increasingly becoming an adult disease and that it can be carried into old age in Africa. Advanced age over 40 is marked by an upsurge in chronic complications, making it essential to set up a screening program and to organize multidisciplinary follow-up.
Copyright © 2024 Moussa Seck et al.
Conflict of interest statement
The authors declare that they have no conflicts of interest.
Figures
Similar articles
-
[Homozygous sickle cell disease in patients above 20 years of age: follow-up of 108 patients in Dakar].Rev Med Interne. 2003 Nov;24(11):711-5. doi: 10.1016/s0248-8663(03)00220-0. Rev Med Interne. 2003. PMID: 14604747 French.
-
Effect of hydroxyurea on mortality and morbidity in adult sickle cell anemia: risks and benefits up to 9 years of treatment.JAMA. 2003 Apr 2;289(13):1645-51. doi: 10.1001/jama.289.13.1645. JAMA. 2003. PMID: 12672732 Clinical Trial.
-
[Sickle cell disease in children in Dakar, Senegal].Arch Pediatr. 2000 Jan;7(1):16-24. doi: 10.1016/s0929-693x(00)88912-5. Arch Pediatr. 2000. PMID: 10668081 French.
-
The influence of fetal hemoglobin on the clinical expression of sickle cell anemia.Ann N Y Acad Sci. 1989;565:262-78. doi: 10.1111/j.1749-6632.1989.tb24174.x. Ann N Y Acad Sci. 1989. PMID: 2476064 Review.
-
[Current developments on sickle cell disease].Rev Med Brux. 2005;26 Spec no:Sp13-22. Rev Med Brux. 2005. PMID: 16454228 Review. French.
References
-
- Ngo Sack F., Seck M., Diop S. Morbidité et Aspects Evolutifs de la Drépanocytose SC: une Étude de 129 Patients au Service d’Hématologie Clinique de Dakar. Health Sciences and Disease . 2016;17(4):p. 6.
-
- Diop S., Diop D., Seck M., et al. [Predictive factors of chronic complications in adult sickle cell anemia patients in Dakar, Senegal] Medecine Tropicale . 2010;70(5-6):471–474. - PubMed
LinkOut - more resources
Full Text Sources