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Observational Study
. 2024 Aug;205(2):664-673.
doi: 10.1111/bjh.19576. Epub 2024 Jun 3.

Determinants of the haemoglobin level in patients with sickle cell disease living in sub-Saharan Africa: Major impact of the country of residence and independent effects of leucocyte and platelet counts and haemolysis

Marica Rossi  1 , Suzanne Belinga  2 , Aissata Tolo  3 , Saliou Diop  4 , Ibrahima Diagne  5 , David Chelo  6 , Guillaume Wamba  7 , Jean Paul Gonzalez  8 , Cochise Abough'elie  8 , Youssouf Traore  9 , Indou Deme-Ly  5 , Moussa Seck  4 , Mor Diaw  4   10   11 , Valerie Gbonon  12 , Kouakou Boidy  3 , Ismael Kamara  4 , Robert Kitenge  13 , Xavier Jouven  1   14 , Léon Tshilolo  13 , Dapa Diallo  9 , Brigitte Ranque  1   15
Affiliations
Observational Study

Determinants of the haemoglobin level in patients with sickle cell disease living in sub-Saharan Africa: Major impact of the country of residence and independent effects of leucocyte and platelet counts and haemolysis

Marica Rossi et al. Br J Haematol. 2024 Aug.

Abstract

The degree of anaemia in sickle cell disease (SCD) is a well-known contributor to morbidity and mortality. We aimed to explore the factors affecting haemoglobin (Hb) level in African SCD patients, considering haemolysis biomarkers (LDH and bilirubin level, and reticulocyte count), leucocyte and platelet counts and socio-demographic characteristics (gender, age group, country of residence and BMI). The research was part of the CADRE multinational cohort and involved 3699 SCD patients living in Mali, Senegal, Ivory Coast, Democratic Republic of Congo, Gabon and Cameroon: 2936 SS/Sβ0, 587 SC and 176 Sβ + patients with median Hb level of 8, 11.3 and 11.2 g/dL respectively (p < 0.001). In multivariate analysis conducted in 1394 SS/Sβ0 patients, living in Cameroon, female gender, lower BMI, higher haemolysis markers (especially LDH) and higher leucocyte and platelet counts were independently associated with lower Hb level (all p < 0.05). In 497 SC and 156 Sβ + patients, female gender (p < 0.001), lower BMI (p < 0.05) and higher platelet counts (p < 0.001) were independently associated with lower Hb level. Anaemia in African SCD patients is not only associated with haemolysis but also with the country of residence, lower BMI and leucocyte or platelet counts which might reflect inflammation related to infectious burden in the region.

Keywords: epidemiology; haemoglobin; haemolysis; sickle cell disease.

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References

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