title: Increased risk of invasive bacterial infections in African people with sickle-cell disease: a systematic review and meta-analysis.
abstract: Children with sickle-cell disease are at great risk of serious infections and early mortality. Our Review investigates the association between sickle-cell disease and invasive bacterial disease among populations in Africa. We systematically searched published work extracted data on pneumonia, meningitis, and bacteraemia by sickle-cell disease status. Most studies identified lacked a control group and did not use best laboratory methods for culturing fastidious bacteria. Only seven case-control or case-cohort studies provided data on the association between invasive bacterial disease and sickle-cell disease status. For all-cause laboratory-confirmed invasive bacterial disease, the pooled odds of sickle-cell disease was 19-times greater among cases than controls. For disease caused by Streptococcus pneumoniae, the pooled odds of sickle-cell disease was 36-times greater; and for Haemophilus influenzae type b disease it was 13-times greater.
authors.affiliation: meenaramakri@gmail.com
authors.forename: Meenakshi
authors.initials: M
authors.lastname: Ramakrishnan
authors.forename: Jennifer C
authors.initials: JC
authors.lastname: Moïsi
authors.forename: Keith P
authors.initials: KP
authors.lastname: Klugman
authors.forename: Jesus M Feris
authors.initials: JM
authors.lastname: Iglesias
authors.forename: Lindsay R
authors.initials: LR
authors.lastname: Grant
authors.forename: Mireille
authors.initials: M
authors.lastname: Mpoudi-Etame
authors.forename: Orin S
authors.initials: OS
authors.lastname: Levine
mesh_terms: D000349:Africa; D000755:Anemia, Sickle Cell / Q000150:complications*; D000818:Animals; D016470:Bacteremia / Q000453:epidemiology; D001424:Bacterial Infections / Q000453:epidemiology*; D002675:Child, Preschool; D006801:Humans; D007223:Infant; D016920:Meningitis, Bacterial / Q000453:epidemiology; D011014:Pneumonia / Q000453:epidemiology; D012307:Risk Factors