Medecine tropicale et sante internationale · 2026
[Care pathway for children with sickle cell disease admitted to the pediatric emergency department at the Cocody University Hospital (Abidjan, Ivory Coast) from January to December 2024].
Аннотация на английскомСтатьяНазвание и аннотация: Перевод в очереди
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Gro Bi André Marius, Mansou Komenan Amoro, Djivohessoun Augustine, Djoman Api Isabelle, N'gatta Assai Prisca, Sorho Domé Charlène, Goli Ahou Corine, Folquet Amorissani Amah
Аннотация
INTRODUCTION: Sickle cell disease leads to numerous complications that require frequent medical care. This study aimed to analyze the care pathway of children with severe sickle cell syndrome who were admitted to the pediatric emergency department at Cocody University Hospital. The goal was to identify factors associated with delayed consultation and promote the early and appropriate management of complications.
METHODOLOGY: This retrospective descriptive study was conducted in the pediatrics department at Cocody University Hospital from January 1 to December 31, 2024. Children with major sickle cell syndrome and a known electrophoretic profile who were hospitalized for an acute complication of the disease were included in the study. The care pathway was analyzed. Data were entered and analyzed using Excel software. Fisher's exact test was used to compare proportions, setting the significance threshold at 5% (p < 0.05).
RESULTS: Of the 800 admissions, 60 children with major sickle cell disease were included, representing a hospital prevalence of 7.5%. The mean age was 5.38 years, ranging from six months to 14 years. The sex ratio was 1.07. Fifty percent of the patients were diagnosed before the age of two, often due to clinical manifestations such as anemia (35%), vaso-occlusive crises (18.3%), and hand-foot syndrome (16.7%). The mean age at diagnosis was 1.8 years ± 8.9, ranging from three months to 12 years. Follow-up was inadequate in 61.7% of cases. In 68.3% of cases, vaccination status was incomplete or undocumented. Patients were referred from a health center in 50% of cases. Of those who received treatment prior to referral, 73.3% were included in the study. The most commonly prescribed drug classes in the outpatient setting were analgesics/antipyretics, antimalarials, and antibiotics, accounting for 63.3%, 23.3%, and 60% of cases, respectively. Delayed consultation was observed in 71.7% of cases and was associated with unfavorable socioeconomic status (p = 0.036), self-medication (p = 0.023), use of traditional medicine (p = 0.02), poor follow-up quality (p < 10-3), and taking analgesics at home (p < 10-3).
CONCLUSION: This study highlights several shortcomings in the care pathway for children with sickle cell disease, particularly delays in seeking medical consultation linked to socioeconomic and cultural factors. A more structured, educational approach to care is essential to improving their prognosis.
METHODOLOGY: This retrospective descriptive study was conducted in the pediatrics department at Cocody University Hospital from January 1 to December 31, 2024. Children with major sickle cell syndrome and a known electrophoretic profile who were hospitalized for an acute complication of the disease were included in the study. The care pathway was analyzed. Data were entered and analyzed using Excel software. Fisher's exact test was used to compare proportions, setting the significance threshold at 5% (p < 0.05).
RESULTS: Of the 800 admissions, 60 children with major sickle cell disease were included, representing a hospital prevalence of 7.5%. The mean age was 5.38 years, ranging from six months to 14 years. The sex ratio was 1.07. Fifty percent of the patients were diagnosed before the age of two, often due to clinical manifestations such as anemia (35%), vaso-occlusive crises (18.3%), and hand-foot syndrome (16.7%). The mean age at diagnosis was 1.8 years ± 8.9, ranging from three months to 12 years. Follow-up was inadequate in 61.7% of cases. In 68.3% of cases, vaccination status was incomplete or undocumented. Patients were referred from a health center in 50% of cases. Of those who received treatment prior to referral, 73.3% were included in the study. The most commonly prescribed drug classes in the outpatient setting were analgesics/antipyretics, antimalarials, and antibiotics, accounting for 63.3%, 23.3%, and 60% of cases, respectively. Delayed consultation was observed in 71.7% of cases and was associated with unfavorable socioeconomic status (p = 0.036), self-medication (p = 0.023), use of traditional medicine (p = 0.02), poor follow-up quality (p < 10-3), and taking analgesics at home (p < 10-3).
CONCLUSION: This study highlights several shortcomings in the care pathway for children with sickle cell disease, particularly delays in seeking medical consultation linked to socioeconomic and cultural factors. A more structured, educational approach to care is essential to improving their prognosis.