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ABSTRACT
Background: Sickle Cell Anaemia (SCA) presents with various types of clinical manifestations that includes
musculoskeletal manifestations that need the intervention of medical personnel including physiotherapy. The study
aimed to determine the various musculoskeletal disorders associated with Sickle Cell Anaemia (SCA), types of
treatmen...
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Introduction: Microalbuminuria (MA) is considered as an early marker of various diseases affecting the renal system. Its relevance in children with sickle cell anaemia (SCA), who are known to be prone to renal complications, has not been fully explored. Microalbuminuria in the early stages of sickle cell nephropathy is a hallmark of future deterior...
Citations
... Other local and international studies have shown slight differences (Balogun et al., 2010, Akaro et al., 2016, Gheldere et al., 2006, Elander, 2013. This could be linked to differences in the methodology employed by these studies or due to inclusion of both adult and children in this study and probably also, due to the higher prevalence of sickle and higher life expectancy in Nigeria than the other study areas (Aliyu et al., 2015). ...
... This study showed prevalence of body pain (182, 55.2%) and (436, 62.6%) among the adults and children participants respectively which implies that only less than half of the participant's experiences pain and it is the most common MSDs among the participants. This is similar to the findings of Chinawa et al. (2013), Elander, (2013, Aliyu et al. (2015) and . This could be attributed to the difference in the setting of the two studies with improved care. ...
Background: While Africa has the highest burden of sickle cell globally, Nigeria has the highest burden in Africa. In Nigeria,
the North-East has the highest burden of the disease. Due to the anaemic nature of the disease, it makes the victims
vulnerable to various musculoskeletal disorders. It became pertinent therefore to explore the pattern of Musculoskeletal
Disorders (MSDs) among Sickle cell Disease (SCD) patients in North-Eastern Nigeria. Methodology: A retrospective study
was conducted for a period of 10 years (January, 2010-December, 2020) at Federal Teaching Hospital Gombe. An
information capture sheet was used to obtain the variables of interest from the patient's case folder within this period.
Results: This study shows a close gender distribution in the adult (Male: 53.2%, Female: 46.8%) and children (Male: 55.2%,
Female: 44.3%) participants. The pattern of MSDs among the participants shows that body pain was the highest MSDs
reported (adults: 55.2%; children: 62.6%) followed by vaso-occlusive crisis (adults: 18.2%; children: 10.5%) and
osteomyelitis (adults: 5.8%; children: 12.9%). From the reported body pain, extremities/joint pains (59.2%), followed by
back pain (14.6%) and generalized body pain (13.4%) were the commonest complaints. Conclusion: The pattern of
distribution of MSDs is similar in the adults and children participants with extremities/joint pains showing prevalence. Early
physiotherapy intervention is strongly recommended for less pain and complications among SCD patients.
... Bone involvement is the most widespread clinical manifestation of SCD, but is perhaps the least well studied. It can present acutely as vaso-occlusive (VOC) bone and joint pain, bony infarcts, osteomyelitis, septic and aseptic arthritis, or as chronic bone deterioration, in which case it manifests as avascular necrosis (AVN), vertebral bone deformities, degenerative arthritis, osteopenia, osteoporosis, Osteogenesis Imperfecta and pathological fractures [14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30]. ...
Introduction: single nucleotide substitution A by T AT 17TH nucleotide of the 6th amino-acid Glutamic acid by valine in beta subunit of Hb (HbA) results in formation of sickle hemoglobin (HbS), Sickle bone syndrome is a public health problem to sicklers (disturbed serum bone minerals and bone density sickle cell crisis pain ). Because of genetic prevalence of sickle anaemia gene in Southern Sudan, sickle cell anaemia is a serious health issue and common cause of paediatrics admission at hospitals and the significance of measuring serum calcium, phosphorous and magnesium clarify the necessity to conduct this study. Which aimed to evaluate Ca, P and Mg Sudanese sicklers and correlate them to bone density and sickle cell crisis pain. Methods: A descriptive Case control study conducted in Southern Darfur Nyala-city involving Sudanese sicklers 50 and age matched control group 50,Hb electrophoresis records and clinical data for patients with sickle disease (known cases of SCD) serum Ca, P, Mg and Albumin were estimated using fully automated chemistry analyzer (Mindray BS-200) for All study groups. Data analysed using SPSS computer software v.24 Results: The results show normal magnesium levels with significant difference between serum magnesium levels among patients (2.43 (0.37) mg/dl) and controls (1.99 (0.47) mg/dl) p value 0.00, the mean serum calcium levels was significantly lower in the sickle cell disease group (8.4 (0.9 mg/dl) compared to controls (9.4 (0.6) mg/dl) p value 0.00. While the mean serum inorganic phosphorous was significantly higher in SCD group (6.6 (1.8) mg/dl) compared to control group (3.9 (0.82) mg/dl). Conclusion: Normomagnesimia hyperphosphatemia and hypocalcaemia are observed in SCD compared to controls.
... [1][2][3] The prevalence of SCD is highest in sub-Saharan Africa, where it is estimated to affect almost 1% of children born each year. 1,4 Although the incidence in Europe is significantly lower, prevalence of SCD has been steadily increasing due to migration. Subsequently, newborn screening was introduced in the United Kingdom in 2006. ...
... In clinical practice, a VOC is a diagnosis of exclusion in children with SCD who present with localized bone pain that improves with fluids, analgesia and anti-inflammatory drugs as per the treatment protocol in Figure 1. 4,[17][18][19]31 From this protocol one can conclude that an afebrile patient with a low CRP is treated as a VOC with continued close assessment for any change. Differentiating between VOC and early OM is a diagnostic challenge and imaging techniques are often used to aid clinical diagnosis. ...
Purpose
The paediatric sickle cell disease (SCD) osteomyelitis (OM) incidence is 0.3% to 12%. Differentiating vaso-occlusive crises (VOC) from OM is a diagnostic challenge, with limited evidence guiding management. We present a 15-year review of a paediatric sickle cell cohort. We aim to identify OM incidence and provide a management protocol for these children presenting with bone pain.
Methods
A prospective database of children with haemoglobinopathies (2002 to 2017) was analyzed for temperature, C-reactive protein (CRP) and white cell count (WCC) on admission as well as imaging, treatment and cultures. OM diagnosis was supported by imaging and blood cultures. VOC was defined as bone pain that improved without antibiotics.
Results
Over 15 years, 96 children with SCD presented 358 times to hospital. Empirical antibiotics were given in 308 presentations. There were five cases of OM (1.4%); two acute and three chronic. In all, 50 presentations of VOC were identified. No significant differences in age were noted between the OM and VOC group. Temperature and CRP were significantly elevated in the OM group with no significant difference in WCC. Cultures were only positive in the chronic OM admissions. There were no cases of septic arthritis. No surgical intervention was required.
Conclusion
In children with SCD presenting with persistent bone pain, fever, elevated CRP and WCC, OM should be suspected and prompt antibiotic treatment started. Our treatment pathway was successful avoiding OM in 98.6% and septic arthritis in 100%. Further research on novel biological markers distinguishing OM from VOC should be investigated.
Level of Evidence
III
... [1][2][3] The prevalence of SCD is highest in sub-Saharan Africa, where it is estimated to affect almost 1% of children born each year. 1,4 Although the incidence in Europe is significantly lower, prevalence of SCD has been steadily increasing due to migration. Subsequently, newborn screening was introduced in the United Kingdom in 2006. ...
... In clinical practice, a VOC is a diagnosis of exclusion in children with SCD who present with localized bone pain that improves with fluids, analgesia and anti-inflammatory drugs as per the treatment protocol in Figure 1. 4,[17][18][19]31 From this protocol one can conclude that an afebrile patient with a low CRP is treated as a VOC with continued close assessment for any change. Differentiating between VOC and early OM is a diagnostic challenge and imaging techniques are often used to aid clinical diagnosis. ...
Purpose
The paediatric sickle cell disease (SCD) osteomyelitis (OM) incidence is 0.3% to 12%. Differentiating vaso-occlusive crises (VOC) from OM is a diagnostic challenge, with limited evidence guiding management. We present a 15-year review of a paediatric sickle cell cohort. We aim to identify OM incidence and provide a management protocol for these children presenting with bone pain.
Methods
A prospective database of children with haemoglobinopathies (2002 to 2017) was analyzed for temperature, C-reactive protein (CRP) and white cell count (WCC) on admission as well as imaging, treatment and cultures. OM diagnosis was supported by imaging and blood cultures. VOC was defined as bone pain that improved without antibiotics.
Results
Over 15 years, 96 children with SCD presented 358 times to hospital. Empirical antibiotics were given in 308 presentations. There were five cases of OM (1.4%); two acute and three chronic. In all, 50 presentations of VOC were identified. No significant differences in age were noted between the OM and VOC group. Temperature and CRP were significantly elevated in the OM group with no significant difference in WCC. Cultures were only positive in the chronic OM admissions. There were no cases of septic arthritis. No surgical intervention was required.
Conclusion
In children with SCD presenting with persistent bone pain, fever, elevated CRP and WCC, OM should be suspected and prompt antibiotic treatment started. Our treatment pathway was successful avoiding OM in 98.6% and septic arthritis in 100%. Further research on novel biological markers distinguishing OM from VOC should be investigated.
... [1][2][3] The prevalence of SCD is highest in sub-Saharan Africa, where it is estimated to affect almost 1% of children born each year. 1,4 Although the incidence in Europe is significantly lower, prevalence of SCD has been steadily increasing due to migration. Subsequently, newborn screening was introduced in the United Kingdom in 2006. ...
... In clinical practice, a VOC is a diagnosis of exclusion in children with SCD who present with localized bone pain that improves with fluids, analgesia and anti-inflammatory drugs as per the treatment protocol in Figure 1. 4,[17][18][19]31 From this protocol one can conclude that an afebrile patient with a low CRP is treated as a VOC with continued close assessment for any change. Differentiating between VOC and early OM is a diagnostic challenge and imaging techniques are often used to aid clinical diagnosis. ...
