Sickle cell children traveling abroad: primary risk is infection.
BACKGROUND
Pediatricians taking care of sickle cell children in France are concerned about giving travel advice. Very few articles are published and no study has been done about it. A lot of pediatricians are using their own experience to decide if sickle cell children can travel abroad. Studying the consequences of such travel for sickle cell children is important to discuss common recommendations.


METHODS
We conducted a prospective study from June 2006 to December 2007 on desires to travel expressed during our consultations with sickle cell children. We studied notable events that occurred during travel and at least 2 months after return.


RESULTS
Of 52 desires to travel, 10 were cancelled. All of the 42 trips were to Africa. Median duration of travel was 1.29 months (0.5-3). Median age at travel was 7.6 years (0.2-17.7). Events during travel were two hospitalizations (4.8%), a transfusion (2.4%), and four paramedical or medical examinations (9.6%). After return, four events occurred: two SS children had Plasmodium falciparum malaria (4.8%) and two had digestive bacteremia (4.8%) in SC and Sbeta+ children. No event occurred during plane travel. None of our patients died.


CONCLUSIONS
The primary risk for sickle cell children traveling to Africa is infection: malaria first and digestive septicemia second. These risks are increased by long travel and poor sanitary conditions. Each travel should be prepared a long time before departure, and each pediatrician should insist on malaria prophylaxis and sanitary conditions, especially for young children. Trips should be shorter than 1 month when possible. A longer prospective study will be done to confirm these results.
Runel-Belliard
Camille
C
Sickle Cell and Travel Consultation Unit, Department of Pediatrics, Armand Trousseau Hospital, Paris, France. camillourun@hotmail.com
Lesprit
Emmanuelle
E
Quinet
Béatrice
B
Grimprel
Emmanuel
E
D000293:Adolescent; D000349:Africa / Q000453:epidemiology; D000755:Anemia, Sickle Cell / Q000150:complications* / Q000628:therapy; D016470:Bacteremia / Q000175:diagnosis / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D003141:Communicable Diseases / Q000453:epidemiology* / Q000209:etiology / Q000628:therapy; D015897:Comorbidity; D006801:Humans; D007223:Infant; D016778:Malaria, Falciparum / Q000175:diagnosis / Q000453:epidemiology; D010297:Paris / Q000453:epidemiology; D010963:Plasmodium falciparum; D011446:Prospective Studies; D012307:Risk Factors; D013997:Time Factors; D014195:Travel