Incidence et facteurs de risque de décès des enfants drépanocytaires suivis à l’Hôpital Saint Camille de Ouagadougou au Burkina Faso

Abstract

Introduction: In Burkina Faso, few data have been reported on the survival of person living with sickle cell disease. We measured the incidence of mortality and identified its risk factors in sickle cell children and adolescents followed as outpatients at Hôpital Saint Camille de Ouagadougou (HOSCO).

Method: We conducted a retrospective cohort study including all children/adolescents under 15 years of age, living with a major sickle cell syndromes who started their clinical follow-up between January 1, 2010 and December 31, 2017 at the HOSCO. The incidence of mortality was estimated using the Kaplan-Meier method. Risk factors for death were identified using a Cox regression model.

Results: A total of 787 children/adolescents were included, with a mean age of 6.71 years (standard deviation: 4.05 years). Mean age at diagnosis was 4.90 years (standard deviation: 3.52 years). The SC genotype was the most common, accounting for 66.07% (520/787), compared with 28.48% (224/787) for the SS genotype. The cumulative incidence of mortality was 2.29% (18/787), with a mortality rate of 0.68 per 100 person-years (95% confidence interval [CI95%]: 0.18-0.21). In multivariate analysis, children with SS genotype had a higher risk of death (Adjusted Hazard Ratio [HRa]: 3.93; CI95%: 1.08-14.22) compared with SC genotype, as did severely anemic children at inclusion compared with those with normal hemoglobin levels (HRa: 4.21; CI95%: 0.58 - 30.34).

Conclusions: Reducing mortality among children/adolescents with sickle cell disease in Burkina Faso requires improved follow-up of patients with SS genotype, as well as prevention and management of severe anemia.