Pulmonary functions of children with sickle cell anaemia in steady state in Lagos, Nigeria

Background: Respiratory disorders are responsible for considerable morbidity and mortality in children with sickle cell anaemia (SCA). Spirometry is a useful tool for the detection and monitoring of respiratory disorders, but it is under-utilized by healthcare workers who care for children with sickle cell anaemia. Most of the studies assessing pulmonary functions in sickle cell anaemia were conducted among adults. Objective: To describe the lung functions profile of children with sickle cell anaemia in steady state. Methodology: In this study, spirometric indices of 100 children with SCA (HbSS) aged five years to 12 years were compared with 100 matched normal children (HbAA) in the control group. Results: Irrespective of gender, the mean Peak Expiratory Flow Rate (PEFR) values were significantly higher among the HbAA controls than their HbSS counterparts. The mean Forced Expiratory Volume in one second (FEV1) values of males and all subjects irrespective of gender were also significantly higher among the controls compared to HbSS subjects. The mean Forced Vital Capacity (FVC) values were higher among HbSS subjects than the HbAA controls, but the observed differences were not significant. The mean FEV1/FVC values were also not significantly different between the SCA subjects and the controls. The overall prevalence of restrictive pulmonary abnormalities among the HbSS group was 6.0% whereas none of the HbAA group had restrictive pulmonary disorders. Conclusion: Children with SCA, irrespective of gender, have significantly lower PEFR and FEV1. Restrictive lung abnormalities occur exclusively among subjects with SCA

IRON DEFICIENCY ANAEMIA AMONG PRE-SCHOOL CHILDREN WITH SICKLE CELL ANAEMIA: STILL A RARE DIAGNOSIS?

Background: The frequent need for blood transfusion in children with SCA creates the impression that IDA is rare in this class of children. Objectives: The objective of the study is to determine the prevalence of IDA in a population of under-five children with SCA in Lagos, Nigeria. Methodology: Serum iron, total iron binding capacity, transferrin saturation and serum ferritin were assayed in 97 under-five children with SCA and 97 age/sex matched controls. The diagnosis of IDA was established based on the following criteria: haemoglobin <11.0 g/dl plus two or more of the following: MCV <70fl, transferrin saturation (Ts) <16% or serum ferritin (SF) <25ng/dL Results: Overall prevalence of IDA was significantly higher among AA controls. In the younger age group, the prevalence of IDA was significantly higher among HbAA controls while in the older age group the odds of having IDA was three times higher among HbSS subjects but the difference was not statistically significant. Two of the three SCA children with IDA have history of previous blood transfusion. Conclusion: IDA is uncommon in pre-school aged children with SCA. A multi-centre study is necessary to yield large number of transfused subjects to examine the effects of blood transfusion on prevalence of IDA

Estimation of Height Using Body Weight and Segmental Measurements in Children with Cerebral Palsy

ObjectivesThe current study aimed to determine the proxy measurements for height in children with Cerebral Palsy (CP).Materials &amp; MethodsIn a cross-sectional descriptive study, the length/height of Nigerian children with CP was studied over eighteen months using descriptive statistics. The study subjects comprised children aged 15 months to 17 years with C P. Height/length, weight, arm span, forearm length, mid-upper arm circumference, foot length, head circumference, hip circumference, leg length, and tibia length were measured to the nearest 0.1 cm using standard procedures. The relations between segmental measurements and weight with height were investigated using linear regression.ResultsA total of 31 children were studied. The correlation between height/ length and other linear measurements has a significantly strong positive relationship. Regression analysis showed that when used singly, the weight and thigh length offered a high explanation for the height variability with little estimation error. On the other hand, weight had a lower mean difference between observed and predicted height (0.21and -0.76, respectively), with thigh length overestimating the height.ConclusionWeight measurement may be the preferred proxy for height in children with C P

Cormic Index Profile of Children with Sickle Cell Anaemia in Lagos, Nigeria

Background. Sickle cell disorders are known to have a negative effect on linear growth. This could potentially affect proportional growth and, hence, Cormic Index. Objective. To determine the Cormic Index in the sickle cell anaemia population in Lagos. Methodology. A consecutive sample of 100 children with haemoglobin genotype SS, aged eight months to 15 years, and 100 age and sex matched controls (haemoglobin genotype AA) was studied. Sitting height (upper segment) and full length or height were measured. Sitting height was then expressed as a percentage of full length/height (Cormic Index). Results. The mean Cormic Index decreased with age among primary subjects (SS) and AA controls. The overall mean Cormic Index among primary subjects was comparable to that of controls (55.0±4.6% versus 54.5±5.2%; 54.8±4.5% versus 53.6±4.9%) in boys and girls, respectively. In comparison with AA controls, female children with sickle cell anaemia who were older than 10 years had a significantly lower mean Cormic Index. Conclusion. There was a significant negative relationship between Cormic Index and height in subjects and controls irrespective of gender. Similarly, a significant negative correlation existed between age, sitting height, subischial leg length, weight, and Cormic Index in both subjects and controls