Health Science Reports (Nov 2022)

Iron stores in steady‐state sickle cell disease children accessing care at a sickle cell disease clinic in Kumasi, Ghana: A cross‐sectional study

  • Ernest Amanor,
  • Alexander Kwarteng,
  • Amma Larbi,
  • Fatima Amponsah Fordjour,
  • Kelvin Kwaku Koranteng,
  • David Sebbie Sackey,
  • Emmanuel Bannor,
  • Francis Adjei Osei,
  • Aliyu Mohammed,
  • Ezekiel Bonwin Ackah,
  • Samuel Frimpong Odoom,
  • Samuel Blay Nguah,
  • Vivian Paintsil,
  • Alex Osei‐Akoto

DOI
https://doi.org/10.1002/hsr2.934
Journal volume & issue
Vol. 5, no. 6
pp. n/a – n/a

Abstract

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Abstract Background and Aims Children with sickle cell disease (SCD) have an increased risk of multiple hemotransfusions and this can predispose them to elevated iron stores. The objectives of the study were to determine the extent of elevated iron stores and the associated risk factors in a population of steady‐state SCD children in Ghana. Methods This cross‐sectional study was conducted at the pediatric sickle cell clinic at the Komfo Anokye Teaching Hospital. Complete blood count and serum ferritin assay were performed for (n = 178) steady‐state SCD children. Descriptive and multivariate logistic regression analysis were performed. Elevated iron stores were defined as serum ferritin levels >300 ng/ml. Statistical significance was considered at p < 0.05. Results The mean (standard deviation) age of the participants was 9.61 (±4.34) years, and 51% of them were males. About 17% of SCD children had elevated iron stores and receiving at least three hemotransfusions during the last 12 months was strongly associated with elevated iron stores (p < 0.001). History of chronic hemotransfusion increased the odds of having elevated iron store (adjusted odds ratio [aOR] = 11.41; 95% confidence interval [CI] = 3.11–30.85; p < 0.001) but SCD patients on hydroxyurea treatment had reduced‐odds of having elevated iron stores (aOR = 0.18; 95% CI = 0.06–0.602; p = 0.006). Moreover, red blood cell (Coef. = −0.84; 95% CI = −0.37, −1.32; p = 0.001), hemoglobin (Coef. = −0.83; 95% CI = −0.05, −1.61; p = 0.04), hematocrit (Coef. = −0.85; 95% CI = −0.08, −1.63; p = 0.03), mean cell volume (Coef. = 0.02; 95% CI = 0.01, 0.03; p = 0.001) and mean cell hemoglobin (Coef. = 0.04; 95% CI = 0.01, 0.07; p = 0.002) could significantly predict serum ferritin levels. Conclusion The magnitude of elevated iron stores was high among children with SCD in steady‐state. Red cell indices could provide invaluable information regarding the risk of elevated iron stores. SCD children who have a history of chronic hemotransfusion or had received at least three hemotransfusions in a year should be monitored for elevated iron stores.

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