Clinical depression in children and adolescents with sickle cell anaemia: influencing factors in a resource-limited setting

Abstract Background Sickle cell anaemia (SCA) is the commonest monogenic haematologic disorder resulting from the inheritance of homozygous mutant haemoglobin genes from both parents. Some factors have been identified as important in explaining the variability in depression in sickle cell anaemia (SCA). Information on this is limited in a resource-limited setting like Nigeria. This study aims to determine factors which influence depression in children and adolescents with sickle cell anaemia in a resource-limited setting. Methods Systematic random sampling technique was used in this cross-sectional study to select children and adolescents aged 7–17 years at the weekly sickle cell clinic of the University of Nigeria Teaching hospital (UNTH) Enugu, Nigeria. Pretested, structured questionnaire was used to collect sociodemographic and disease severity data while depression was assessed using the Children’s Depression Inventory. Results Age and educational level had significant positive linear relationships with depression (r = 0.253, p = 0.02; r = 0.225, p = 0.04 respectively) while gender (χ2 = 0.531, p = 0.466), socioeconomic status (χ2 = 0.451, p = 0.798) and disease severity (χ2 = 0.422, p = 0.810) had no relationship with depression in children and adolescents with SCA. Conclusion Depression in children and adolescents with SCA increased with increasing age and educational level. Psychological evaluation should be integrated into routine assessment of children with SCA during their follow up visits as they get older and progress in class.

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Clinical Depression in Children and Adolescents With Sickle Cell Anaemia: Influencing Factors in a Resource-limited Setting

10.21203/rs.3.rs-294737/v1 ◽

2021 ◽

Author(s):

Osita Uchenna Ezenwosu ◽

Barth Friday Chukwu ◽

Ifeyinwa Lilian Ezenwosu ◽

Ndubuisi Anyaele Uwaezuoke ◽

Christopher Bismarck Eke ◽

...

Keyword(s):

Children And Adolescents ◽

Disease Severity ◽

Sickle Cell ◽

Educational Level ◽

Sickle Cell Anaemia ◽

Sampling Technique ◽

Resource Limited Setting ◽

Cross Sectional ◽

Resource Limited ◽

Limited Setting

Abstract Background: Sickle cell anaemia (SCA) is the commonest monogenic haematologic disorder resulting from the inheritance of homozygous mutant haemoglobin genes from both parents. Some factors have been identified as important in explaining the variability in depression in sickle cell anaemia (SCA). Information on this is limited in a resource-limited setting like Nigeria. This study aims to determine factors which influence depression in children and adolescents with sickle cell anaemia in a resource-limited setting.Methods: Systematic random sampling technique was used in this cross-sectional study to select children and adolescents aged 7-17 years at the weekly sickle cell clinic of the University of Nigeria Teaching hospital (UNTH) Enugu, Nigeria. Pretested, structured questionnaire was used to collect sociodemographic and disease severity data while depression was assessed using the Children’s Depression Inventory.Results: Age and educational level had significant positive linear relationships with depression (r = 0.253, p = 0.02; r = 0.225, p = 0.04 respectively) while gender (χ2 = 0.531, p = 0.466), socioeconomic status (χ2 = 0.451, p = 0.798) and disease severity (χ2 = 0.422, p = 0.810) had no relationship with depression in children and adolescents with SCA.Conclusion: Depression in children and adolescents with SCA increased with increasing age and educational level. Psychological evaluation should be integrated into routine assessment of children with SCA during their follow up visits as they get older and progress in class.

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Relationship between disease severity and folate status of children with sickle cell anaemia in Enugu, South East Nigeria

African Health Sciences ◽

10.4314/ahs.v21i2.35 ◽

2021 ◽

Vol 21 (2) ◽

pp. 759-764

Author(s):

Uchenna C Nnajekwu ◽

Chukwubike O Nnajekwu ◽

Vivian O Onukwuli ◽

Ndubuisi A Uwaezuoke ◽

Osita U Ezenwosu ◽

...

Keyword(s):

Disease Severity ◽

Sickle Cell ◽

Severity Score ◽

Sickle Cell Anaemia ◽

Life Time ◽

Folate Deficiency ◽

Relevant Information ◽

Folate Supplementation ◽

Cross Sectional ◽

Folate Status

Background: Repeated crises in children with sickle cell anaemia (SCA), which is a manifestation of disease severity, results in depletion of their minimal tissue folate stores, with higher likelihood of folate deficiency. The study aimed to determine the relationship between disease severity and the folate status of children with SCA attending University of Nigeria Teaching Hospital (UNTH), Enugu. Methods: This was a hospital based, cross-sectional study conducted between September 2018 and March 2019. One hundred participants were recruited, consisting of 50 children having sickle cell crisis and 50 age and gender matched hae- moglobin AA genotype controls. Relevant information was documented using a pretested questionnaire. Sickle cell severity score was determined using frequency of crisis, admissions and transfusions in the preceding one year, degree of liver and splenic enlargement, life-time cummulative frequency of specific complications of SCA, leucocyte count and haematocrit. Results: Folate deficiency was observed in eight percent of the subjects and none of the controls. The difference was not significant (Fisher’s exact = 4.167, p=0.117). The odds of being folate deficient was 8.5 times more likely during anaemic crisis than in vaso-occlusive crisis, though not significant (95% C.I 0.05 – 89.750, p = 0.075). The mean SCA severity score was 8.06 ± 3.64, signifying a moderate SCA severity in the study population. There was a no relationship between folate status and severity of SCA (Fisher’s exact = 0.054, p = 0.949) Conclusion: Folate status in children with SCA is not affected by their disease severity. Therefore, there may be no need for additional folate supplementation with increasing severity of sickle cell anaemia. Keywords: Sickle cell anaemia; disease severity; folate status; children; Enugu.

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