Asare Eugenia V, Wilson Ivor, Benneh-Akwasi Kuma Amma A, Dei-Adomakoh Yvonne, Sey Fredericka, Olayemi Edeghonghon
Ghana Institute of Clinical Genetics, Korle-Bu, Accra, Ghana.
Department of Haematology, Korle-Bu Teaching Hospital, Accra, Ghana.
Adv Hematol. 2018 Dec 2;2018:6161270. doi: 10.1155/2018/6161270. eCollection 2018.
In Africa, sickle cell disease (SCD) is a major public health problem with over 200,000 babies born per year. In Ghana, approximately 15,000 (2%) of Ghanaian newborns are diagnosed with SCD annually. A retrospective review of medical records of all SCD patients aged 13 years and above, who presented to the sickle cell clinic at Ghana Institute of Clinical Genetics (GICG), Korle-Bu, from 1st January 2013 to 31st December 2014, was carried out, using a data abstraction instrument to document their phenotypes, demographics, attendance/clinic visits, pattern of attendance, and common complications seen. During the period under review 5,451 patients were seen at the GICG, with 20,788 clinic visits. The phenotypes were HbSS (55.7%) and HbSC (39.6%) with other sickle cell phenotypes (4.7%). Out of the 20,788 clinic visits, outpatient visits were 15,802 (76%), and urgent care visits were 4,986 (24%), out of which 128 (2.6%) patients were admitted to the Teaching Hospital for further management of their acute complications. There were 904 patient referrals (out of 5,451 patients) for specialist care; the 3 specialties that had the most referrals were Obstetrics and Gynaecology (168 patients), Orthopaedics (150 patients), and Ophthalmology (143 patients). In 2014, complications seen at KBTH included 53 patients with avascular necrosis (AVN) and 61 patients with chronic leg ulcers. Our centre has a large number of patients living with sickle cell disease. From our experience, early recognition and referral of sickle cell related complications can reduce morbidity and mortality associated with this disease. A multidisciplinary approach to care of SCD patients is therefore important.
在非洲,镰状细胞病(SCD)是一个重大的公共卫生问题,每年有超过20万名婴儿出生时患有该病。在加纳,每年约有15000名(2%)新生儿被诊断为患有镰状细胞病。对2013年1月1日至2014年12月31日期间在科勒-布的加纳临床遗传学研究所(GICG)镰状细胞诊所就诊的所有13岁及以上镰状细胞病患者的病历进行了回顾性研究,使用数据提取工具记录他们的表型、人口统计学信息、就诊情况/门诊次数、就诊模式以及常见并发症。在审查期间,GICG共接待了5451名患者,门诊就诊次数为20788次。表型为血红蛋白SS(HbSS,55.7%)和血红蛋白SC(HbSC,39.6%),其他镰状细胞表型占4.7%。在20788次门诊就诊中,门诊就诊15802次(76%),紧急护理就诊4986次(24%),其中128名(2.6%)患者因急性并发症被收治入院接受进一步治疗。共有904名患者(在5451名患者中)被转诊至专科进行治疗;转诊最多的三个专科是妇产科(168名患者)、骨科(150名患者)和眼科(143名患者)。2014年,在科勒-布教学医院(KBTH)观察到的并发症包括53例无血管性坏死(AVN)患者和61例慢性腿部溃疡患者。我们中心有大量镰状细胞病患者。根据我们的经验,早期识别和转诊镰状细胞相关并发症可降低与该病相关的发病率和死亡率。因此,采用多学科方法护理镰状细胞病患者很重要。