Sickle cell disease associated co-morbidity with pneumonia outcomes among under-five children referred to university teaching hospital between 2011-2014 in Lusaka, Zambia

Abstract

Pneumonia in sickle cell disease (SCD) can be particularly severe and has come to be called acute chest syndrome (ACS). ACS is a frequent complication of sickle cell disease in patients hospitalized with vaso-occlusive crisis (VOC). It is associated with a high risk of sickle cellrelated mortality and morbidity in children, including prolonged hospitalization. The aims of this study were to determine the prevalence of pneumonia in sickle cell disease, and also to determine cells that are mostly associated with pneumonia in sickle cell disease. Furthermore, were to determine outcomes of pneumonia in SCD and pneumonia for under-five children referred to University Teaching Hospital. The study employed a cross-sectional design, using secondary dataset from paediatrics wing within University Teaching Hospital. Complete enumeration was applied. Continuous data were summarised by means and standard deviation while frequencies and percentages were used for categorical data. The data was analysed using STATA version 13.0 (Stata Corporation, College Station, TX). Logistic regression was applied to assess associations of study variables. A total of 601 under-five children with pneumonia was studied for their pneumonia in SCD. Out of 601 under-five children, 84 had pneumonia in SCD, while 517 had pneumonia only. The under-five children comprised of 53% (n=317) males and 47% (n=284) females, their ages ranged from 28 days to 59 months years old, with a mean age (±SD) of 2.8 ± 1.4 months years old. The prevalence of pneumonia in sickle cell disease was 14%. Mortality for pneumonia in SCD was 12.8% (n=15) while in pneumonia only was 87.2% (n=102). Furthermore we established haemoglobin, red blood cells, white blood cells, mean cell haemoglobin and monocytes as cells that are mostly associated with pneumonia in SCD. The study achieved its set objectives, by determining pneumonia in SCD prevalence, haematological parameters which are mostly associated with pneumonia in SCD, and the outcomes of pneumonia in SCD. Therefore, the government through the Ministry of Health and other partners need to formulate policies towards the reduction of pneumonia in sickle cell disease burden in Zambia. Key terms: Sickle Cell Disease (SCD), Co-Morbidity, Pneumonia Outcomes