Prevalence of iron deficiency in children with Sickle Cell Anaemia at Muhimbili National Hospital

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University of Dar es Salaam
Bacground Sickle cell anaemia is a genetically inherited haemoglobinopathy and is among the major cause of severe anaemia in children in Tanzania. The anaemia is of haemolytic type but several studies have reported iron deficiency anaemia in these patients. (20,21,22) The possible cause of severe of iron deficiency in these children have been speculated to be similar to non-sickler children. (20) Objective To determine the prevalence of iron deficiency and possible contributing factors in sickle cell anaemia patients. Study design A cross section descriptive study Study setting The study was conducted at the paediatric out patient clinic for sickle cell anaemia of Muhimbili National Hospital in Dar es Salaam, from August 2002 to February 2003. Subjects A total of 100 children aged between 6 months to 10 years inclusive attending outpatient sickle cell clinic, were recruited into study. Methodology All haemoglobin SS patient between 6 and 10 years inclusive who actually attended the sickle cell clinic, and whose parents/guardians consented for study were enrolled. Simple random technique was used to select the patients. Five milliliters of blood was taken from all children for Serum ferritin, Serum iron, Total Iron Binding Capacity (TIBC), full blood count and peripheral smear. Main outcome measure The main outcome measure was the magnitude of iron deficiency anaemia Results One hundred patients were recruited during the study period. Males were forty-seven (47%) and fifty-three (53%) were females. Forty-five children (45%) were under five years of ages. Thirteen (13%) patients had iron deficiency. Females were more Iron deficient than males. The prevalence of iron deficiency was not significantly influenced by sex (p- value=0.208). there were slightly more patients with iron deficiency in children less than 60 months age (16.2%)compasred to those above 60 months age (10.5%) The difference was not statistically significant (p-value=0.397). dietary intake, presence of hookworm and level of hemoglobin concentration did not significantly influence the body iron status (p-values were 0.589, 0.426 and 0.491 respectively). Conclusions and Recommendation Iron deficiency occurs in patients with sickle cell anaemia, Age, sex, dietary iron intake, and hookworm infection did not influence body iron status. It is recommended that sickle cell anaemic patients on regular folic acid and chloroquine prophyaxis whose haemoglobin levels are consistently low without the apparent cause of severe anaemia should have blood taken for full blood picture. All patients with a microcytic hypochromic type of anaemia should be investigated for iron deficiency
Available in print form, East Africana Collection, Dr.Wilbert Chagula Library, class mark (THS EAF RC641.7.I7M3)
Sickle cell anaemia, Pediatrics
Mangosongo, B (2003) Prevalence of iron deficiency in children with Sickle Cell Anaemia at Muhimbili National Hospital,Masters dissertation,University of Dar es Salaam, Dar es Salaam.