Factors associated with sickle cell disease mortality among hospitalized Angolan children and adolescents.
BACKGROUND
Sickle cell disease complications are an important mortality cause in children mainly in Africa and India. Notwithstanding the magnitude of the problem on the African continent, studies identifying factors related to the adverse outcomes of sickle cell disease in the pediatric population are still scarce.


OBJECTIVE
To identify prognostic factors associated with mortality in children and adolescent aged under fifteen years with diagnosis of sickle cell disease.


METHODS
Patients meeting inclusion criteria were listed and randomly selected. Clinical and laboratory data collected at time of admission were collected from medical records through the use of standard forms. The association between mortality and explanatory variables was tested using univariable and multivariable analysis.


RESULTS
The overall mortality rate was 64 (12.9%), and bacterial infections 26 (40.1%) were the most common cause of death. Place of residence out of Luanda, lack of outpatient follow-up, symptoms onset more than three days, disease manifestation before age of eighth months and hemoglobin level of < 7 g/dl were independent risk factors related to death. In the study population, sickle cell related deaths were related to quality of health care and access to care.


CONCLUSIONS
The creation of regional sickle cell disease centers to support those afflicted by the disorder and their families would contribute to reduce the burden associated with the disease.
Van-Dunem
J C Carlos
JC
Hospital Pediátrico de Luanda, Universidade Agostinho Neto, Luanda, Angola, Brazil.
Alves
J G B
JG
Bernardino
Luis
L
Figueiroa
José Natal
JN
Braga
Cynthia
C
do Nascimento
Maria de Lourdes Pires
Mde L
da Silva
Sérgio José
SJ
D000293:Adolescent; D000755:Anemia, Sickle Cell / Q000401:mortality*; D000810:Angola / Q000453:epidemiology; D002423:Cause of Death; D002648:Child; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D016015:Logistic Models; D008297:Male; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors