Research Article
Volume 9 Issue 7 - 2020
Hospitalization Events among Children with Sickle Cell Disease in Ho, Ghana
Kokou H Amegan-Aho1,2*, Patience Kuwornoo2, Avery Macintosh3, Kwabena O Duedu4 and Jonathan Spector3
1Department of Paediatrics and Child Health, School of Medicine, University of Health and Allied Sciences, Ho, Ghana
2Department of Child Health, Volta Regional Hospital, Ho, Ghana
3Novartis Institute for Biomedical Research, Cambridge, USA
4Department of Biomedical Sciences, School of Basic and Biomedical Sciences, University of Health and Allied Sciences, Ho, Ghana
*Corresponding Author: Kokou H Amegan-Aho, Department of Paediatrics and Child Health, School of Medicine, University of Health and Allied Sciences, Ho, Ghana.
Received: January 23,2020; Published: June 26, 2020


Background: Sickle cell disease (SCD) is common in Ghana and is associated with high morbidity and mortality, especially in the paediatric population. In Volta Region, one of Ghana’s ten provinces, the major drivers of harm in children with SCD has not previously been systematically explored. We sought to characterize hospitalization events among paediatric patients with SCD in a regional hospital in order to inform local quality improvement efforts.

Methods: Medical records were retrospectively investigated for all children aged 6 months to 12 years with SCD that were admitted to the Volta Regional Hospital (Ho, Ghana) from January to December 2016. Descriptive analyses were conducted for patient demographics, hospitalization events, and clinical outcomes. Multiple admission diagnoses were allowable. Bivariate analyses using Cross-tabulation and Chi-Square were employed to evaluate associations among study variables.

Results: Sixty-five admissions were recorded for 51 children with SCD, which accounted for 5% of all paediatric hospitalizations during the study period. The mean age at which patients had been diagnosed with SCD was 4.2 ± 3.4 years (range: 3 months-16 years), and the mean age at admission was 6 ± 2.6 years. There was a slight predominance of males (53% males vs. 47% females) and the haemoglobin phenotypes were Hb SS (n = 44; 86%) and Hb SC (n = 7; 14%). The most common causes for admission were vaso-occlusive crisis (81.3%) and infection (70.3%). Plasmodium falciparum malaria was the etiologic agent in one-third of patients admitted with infection (n = 14; 31%). All children received intravenous fluids during admission and 17 children (28%) received blood transfusions. The mean length of stay was 4.9 ± 3 days. There was no mortality.

Conclusion: Sickle cell disease is a substantial cause of paediatric hospital admissions in the study setting. The variable age at which individuals are diagnosed with SCD highlights a fundamental health systems gap in newborn screening and clinical management in early childhood. The commonest reasons for admission (vaso-occlusive crisis and infection) may be preventable in some patients. Future work will involve incorporation of directed anticipatory guidance into outpatient visits for children with SCD with the hopes that improved education for families about the disease may help to reduce severe complications that require hospitalization.

Keywords: Children; Sickle Cell Disease (SCD); Ghana


  1. Bunn H. “Pathogenesis and treatment of sickle cell disease”. New England Journal of Medicine 337.11 (1997): 762-769.
  2. Piel FB., et al. “Sickle Cell Disease”. New England Journal of Medicine 376.16 (2017): 1561-1573.
  3. Ohene-Frempong K., et al. “Screening Newborns for Sickle Cell Disease in Ghana”. Pediatrics 121 (2008). 
  4. Fisher AE., et al. “Presentations of sickle cell disease patients to hospital in Ghana: key findings from a preliminary study at Volta Regional Hospital”. British Journal of Haematology (2016). 
  5. Booth C., et al. “Infection in sickle cell disease: A review”. International Journal of Infectious Diseases 14.1 (2010): 2-12. 
  6. Ramakrishnan M., et al. “Increased risk of invasive bacterial infections in African people with sickle-cell disease: a systematic review and meta-analysis”. Lancet Infectious Diseases 10.5 (2010): 329-337. 
  7. Nielsen MV., et al. “Incidence and Characteristics of Bacteremia among Children in Rural Ghana”. PLos One 7.9 (2012): e0044063.
  8. Sothmann P., et al. “Urbanicity and Paediatric Bacteraemia in Ghana - A Case-Control Study within a Rural- Urban Transition Zone”. PLos One (2015): 1-11. 
  9. Nkrumah NO., et al. “Trends in paediatric and adult bloodstream infections at a Ghanaian referral hospital: a retrospective study”. Annals of Clinical Microbiology and Antimicrobials (2016): 1-10. 
  10. Makani J., et al. “Mortality in Sickle Cell Anemia in Africa: A Prospective Cohort Study in Tanzania”. PLoS One 6.2 (2011): e14699. 
  11. Ansong D., et al. “Sickle cell disease: Management options and challenges in developing countries”. Mediterranean Journal of Hematology and Infectious Diseases 5.1 (2013): 1-6. 
  12. Ministry of Health. Standard Treatment Guidelines. Sixth edition. (Ghana National Drugs Programme, edition). Accra, Ghana (2010). 
  13. Sadarangani M., et al. “An observational study of children with sickle cell disease in Kilifi, Kenya”. British Journal of Haematology 146.6 (2009): 675-682. 
  14. Akinbami A., et al. “Haematological values in homozygous sickle cell disease in steady state and haemoglobin phenotypes AA controls in Lagos, Nigeria”. BMC Research Notes 5 (2012): 396. 
  15. Gomez S., et al. “Comparative analysis of iron homeostasis in sub-Saharan African children with sickle cell disease and their unaffected siblings”. Frontiers in Pediatrics 4 (2016). 
  16. World Health Organization. Department of Nutrition for Health and Development. Iron Deficiency Anaemia: Assessment, Prevention and Control: A Guide for Programme Managers. (Geneva: World Health Organization, edition). Geneva, Switzerland (2001).
Citation: Kokou H Amegan-Aho., et al. “Hospitalization Events among Children with Sickle Cell Disease in Ho, Ghana”. EC Paediatrics 9.7 (2020): 01-07.

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