death in the present study attributed to blood transfusion
reaction. It is therefore necessary to counsel and support
parents and patients on prompt health seeking habits
that minimize the risk of severe anaemia and subsequent
Hospital admission of children with sickle cell disease in
Ibadan, Nigeria results from a wide variety of clinical
conditions but mainly infections and various forms of
crises. There is a need to clearly establish the aetiologic
agents of infections in these children to guide appropri-
ate antimicrobial therapy. The use of prophylaxis
against pneumococcal infections if supported by evi-
dence, has a great potential of reducing morbidity and
mortality 1as has been shown in the United States of
Hospitalization of children with SCD constitutes a sig-
nificant burden on the caregivers. The median duration
of hospitalization in the present study is similar to find-
ings reported in the United Kingdom. In addition, the
findings of the present study indicate that individuals
with septicaemia, acute osteomyelitis, cerebrovascular
accident and avascular necrosis of the femoral head
were at increased risk of prolonged admission. In an
attempt to lighten the burden of admissions, some hos-
pitals instituted carrying out elective blood transfusion1s7
in day care settings without overnight admissions.
Considering the finding that almost 40 percent of our
study patients required blood transfusion, provision and
utilization of daycare settings may go a long way in re-
ducing the frequency of hospital admissions particularly
in children in whom no major infection or complication
needing prolonged admission is found.
America. There is also need for establishment of com-
prehensive programmes for sickle cell disease in Nigeria
to improve the quality of life of affected children. This
should include neonatal diagnosis and early institution
of health promoting measures and regular screening tests
for possible complications such as risks for stroke.
Unhindered access to health care is also paramount in
relieving the financial burden borne by caregivers and
therefore giving the children a better chance of survival.
Conflict of interest: None
The case fatality observed in this study was lower than
cell anaemia in Zambia and 8.5 per cent in Enugu Ni-
geria. Although the small number of deaths in our
.61 percent observed in8 admitted children with sickle
study makes it difficult to make strong conclusions on
the pattern of mortality, the fact that two out of the three
deaths were related to cerebrovascular accidents calls for
the need to strengthen measures towards primary stroke
prevention. This need is further heightened by the rela-
tively high contribution of stroke to admissions. Routine
screening of children with SCD by Transcranial Doppler
ultrasonography to detect high risk cases and institution
The role of resident, consultant and laboratory staff in
the management of children with SCD in the department
is acknowledged. The resident doctors were also of as-
sistance in data collection.
of appropriate preventive measures is recommended.
Blood transfusion greatly reduces the risk of a first
stroke in children with sickle cell anaemia who have
abno1r9mal results on transcranial Doppler ultrasonogra-
The low yield of bacterial isolates among patients
treated for sepsis partly due to inability of the parents to
pay for microbial cultures make the results on aetiologi-
cal organisms of limited value for generalization.
Juwah AI, Nlemadim E U, Kaine
9. Brozovic M, Davies S C, Alison I
Brownell AI. Acute admissions of
patients with sickle cell disease
who live in Britain. Br Med J
10. Address correspondence and re-
print requests to Marian B. Fosdal,
MA, RN, CPON®, Riley Chil-
dren's Cancer Center, 702 Barnhill
Drive, #1960 Indianapolis, IN
11. Fosdal M B, Woiner-Alexandrov
A W. Events of Hospitalization
among Children with Sickle Cell
Disease. J Pediatr Nurs 2007;
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paediatric patients with sickle cell
anaemia seen in Enugu, Nigeria.
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tients with sickle cell disease re-
quiring admission. J Trop Pediatr
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