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Segbefia C, Campbell J, Tartaglione I, Asare EV, Andemariam B, Zempsky W, Colombatti R, Boatemaa GD, Boruchov D, Rao S, Piccone CM, Smith A, Haile H, Kim E, Wilson S, Farooq F, Urbonya R, Rivers A, Manwani D, Gai J, Sey F, Inusa B, Antwi-Boasiako C, Strunk C, Campbell AD. Pain Frequency and Health Care Utilization Patterns in Women with Sickle Cell Disease Experiencing Menstruation-Associated Pain Crises. J Womens Health (Larchmt) 2023; 32:1284-1291. [PMID: 38011013 DOI: 10.1089/jwh.2023.0023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2023] Open
Abstract
Background: Pain crises in sickle cell disease (SCD) lead to high rates of health care utilization. Historically, women have reported higher pain burdens than men, with recent studies showing a temporal association between pain crisis and menstruation. However, health care utilization patterns of SCD women with menstruation-associated pain crises have not been reported. We studied the frequency, severity, and health care utilization of menstruation-associated pain crises in SCD women. Materials and Methods: A multinational, cross-sectional cohort study of the SCD phenotype was executed using a validated questionnaire and medical chart review from the Consortium for the Advancement of Sickle Cell Research (CASiRe) cohort. Total number of pain crises, emergency room/day hospital visits, and hospitalizations were collected from a subcohort of 178 SCD women within the past 6 months and previous year. Results: Thirty-nine percent of women reported menstruation-associated pain crises in their lifetime. These women were significantly more likely to be hospitalized compared with those who did not (mean 1.70 vs. 0.67, p = 0.0005). Women reporting menstruation-associated pain crises in the past 6 months also experienced increased hospitalizations compared with those who did not (mean 1.71 vs. 0.75, p = 0.0016). Forty percent of women reported at least four menstruation-associated pain crises in the past 6 months. Conclusions: Nearly 40% of SCD women have menstruation-associated pain crises. Menstruation-associated pain crises are associated with high pain burden and increased rates of hospitalization. Strategies are needed to address health care disparities within gynecologic care in SCD.
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Affiliation(s)
- Catherine Segbefia
- Department of Child Health, University of Ghana Medical School, Accra, Ghana
- Department of Child Health, Korle Bu Teaching Hospital, Accra, Ghana
| | - Jillian Campbell
- Center for Cancer and Blood Disorders, Children's National Hospital, Washington, District of Columbia, USA
| | - Immacolata Tartaglione
- Department of Women, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli," Naples, Italy
| | | | - Biree Andemariam
- Division of Hematology-Oncology, New England Sickle Cell Institute, Neag Comprehensive Cancer Center, University of Connecticut, Farmington, Connecticut, USA
| | - William Zempsky
- Department of Pediatrics, Connecticut Children's Medical Center, Hartford, Connecticut, USA
| | - Raffaella Colombatti
- Department of Women's and Child Health, Clinic of Pediatric Hematology Oncology, Azienda Ospedaliera-Università di Padova, Padova, Italy
| | - Gifty Dankwah Boatemaa
- Department of Physiology, University of Ghana Medical School, University of Ghana, Accra, Ghana
| | - Donna Boruchov
- Department of Pediatrics, Connecticut Children's Medical Center, Hartford, Connecticut, USA
| | - Sudha Rao
- Department of Child Health, Korle Bu Teaching Hospital, Accra, Ghana
| | - Connie M Piccone
- Department of Pediatric Hematology/Oncology, Rainbow Babies and Children's Hospital, Cleveland, Ohio, USA
| | - Ashya Smith
- Division of Pediatric Hematology/Oncology, University of Michigan, Ann Arbor, Michigan, USA
| | - Haikel Haile
- Division of Pediatric Hematology/Oncology, University of Michigan, Ann Arbor, Michigan, USA
| | - Esther Kim
- Division of Pediatric Hematology/Oncology, University of Michigan, Ann Arbor, Michigan, USA
| | - Samuel Wilson
- Division of Pediatric Hematology/Oncology, University of Michigan, Ann Arbor, Michigan, USA
| | - Fatimah Farooq
- Division of Pediatric Hematology/Oncology, University of Michigan, Ann Arbor, Michigan, USA
| | - Rebekah Urbonya
- Division of Pediatric Hematology/Oncology, University of Michigan, Ann Arbor, Michigan, USA
| | - Angela Rivers
- Department of Pediatrics, University of California San Francisco, San Francisco, California, USA
| | - Deepa Manwani
- Department of Pediatrics, Albert Einstein College of Medicine, Children's Hospital at Montefiore, Bronx, New York, USA
| | - Jiaxiang Gai
- Division of Biostatistics and Study Methodology, Children's National Hospital, George Washington University School of Medicine and Health Sciences, Washington, District of Columbia, USA
| | - Fredericka Sey
- Ghana Institute of Clinical Genetics, Korle Bu Teaching Hospital, Accra, Ghana
| | - Baba Inusa
- Department of Pediatric Haematology, Evelina Children's Hospital, Guy's and St. Thomas NHS Trust, College of Nursing, London, United Kingdom
| | - Charles Antwi-Boasiako
- Department of Physiology, University of Ghana Medical School, University of Ghana, Accra, Ghana
- College of Health Nursing, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin, USA
| | - Crawford Strunk
- Pediatric Hematology Oncology and Blood and Marrow Transplantation, Cleveland Clinic Foundation, Cleveland, OH, USA
| | - Andrew D Campbell
- Center for Cancer and Blood Disorders, Children's National Hospital, Washington, District of Columbia, USA
- Division of Pediatric Hematology/Oncology, University of Michigan, Ann Arbor, Michigan, USA
- Division of Hematology, Department of Pediatrics, Children's National Hospital, George Washington University School of Medicine and Health Sciences, Washington, District of Columbia, USA
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Dei-Adomakoh Y, Effah K, Tekpor E, Crabbe S, Amuah JE, Wormenor CM, Tay G, Asare EV, Kemawor S, Danyo S, Morkli EAC, Tibu F, Essel NO, Akakpo PK. Cervical precancer screening with HPV DNA testing and mobile colposcopy in women with sickle cell disease in Accra, Ghana. Ecancermedicalscience 2023; 17:1571. [PMID: 37533951 PMCID: PMC10393310 DOI: 10.3332/ecancer.2023.1571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Indexed: 08/04/2023] Open
Abstract
Background Worldwide, about 20-25 million people are affected by sickle cell disease (SCD), with 60% of patients living in sub-Saharan Africa. Despite recent therapeutic advancements resulting in improved life expectancy among SCD patients, the prevalence of high-risk human papillomavirus (hr-HPV) and cervical lesions have not been studied in women with SCD. We determined the prevalence of hr-HPV and cervical lesions among women with SCD and recommended strategies for reducing cervical cancer incidence in this cohort. Methods Through the mPharma 10,000 Women Initiative, women with SCD attending routine visits at the Ghana Institute of Clinical Genetics SCD clinic were screened by trained nurses. Screening was performed via concurrent MA-6000 hr-HPV DNA testing and enhanced visual assessment (EVA) mobile colposcopy from mobileODT. Results Among 168 participants screened (mean age, 43.0 years), the overall prevalence rates of hr-HPV infection and cervical lesions were 28.6% (95% CI, 21.7-35.4) and 3.6% (95% CI, 0.8-6.4), respectively. The hr-HPV prevalence rates stratified by haemoglobin genotype were 29.4% (95% CI, 19.7-39.1) and 28.6% (95% CI, 18.5-38.7) for genotypes SS and SC, respectively. None of the five women with the SF genotype tested hr-HPV positive, and the only patient with Sbthal genotype tested hr-HPV positive. Two women were EVA 'positive' but hr-HPV negative, whereas four were EVA positive and hr-HPV positive. Exploratory analysis revealed no significant associations between hr-HPV positivity and age, education level, marital status or parity. Conclusion In the absence of a comprehensive national cervical screening programme aimed at including women with SCD as a special population, cervical cancer may increase in frequency among SCD patients. Thus, there is a need to build capacity and expand the scope of screening services for women with SCD.
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Affiliation(s)
- Yvonne Dei-Adomakoh
- Korle-Bu Teaching Hospital, Ghana Institute of Clinical Genetics, Accra, Ghana
- Department of Haematology, University of Ghana Medical School, Accra, Ghana
- https://orcid.org/0000-0002-2017-2569
| | - Kofi Effah
- Catholic Hospital, Battor, Ghana
- https://orcid.org/0000-0003-1216-2296
| | | | - Selina Crabbe
- Korle-Bu Teaching Hospital, Ghana Institute of Clinical Genetics, Accra, Ghana
| | - Joseph Emmanuel Amuah
- Catholic Hospital, Battor, Ghana
- Faculty of Medicine, School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON K1H 8M5, Canada
| | | | | | - Eugenia Vicky Asare
- Korle-Bu Teaching Hospital, Ghana Institute of Clinical Genetics, Accra, Ghana
- Department of Haematology, Korle-Bu Teaching Hospital, Accra, Ghana
| | | | | | | | | | - Nana Owusu Essel
- Department of Emergency Medicine, Faculty of Medicine & Dentistry, College of Health Sciences, University of Alberta, Edmonton, AB T6G 2T4, Canada
- https://orcid.org/0000-0001-5494-5411
| | - Patrick Kafui Akakpo
- Department of Pathology, Clinical Teaching Center, School of Medical Sciences, University of Cape Coast, Cape Coast, Ghana
- https://orcid.org/0000-0003-0356-0663
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Asare EV. Acute pain episodes, acute chest syndrome, and pulmonary thromboembolism in pregnancy. Hematology Am Soc Hematol Educ Program 2022; 2022:388-407. [PMID: 36485167 PMCID: PMC9821602 DOI: 10.1182/hematology.2022000376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
Pregnancy in women with sickle cell disease (SCD) is a life-threatening condition. In both high- and low-income countries, there is an 11-fold increased risk of maternal death and a 4-fold increased risk of perinatal death. We highlight the epidemiology of SCD-specific and obstetric complications commonly seen during pregnancy in SCD and propose definitions for acute pain and acute chest syndrome (ACS) episodes during pregnancy. We conducted a systematic review of the recent obstetric and hematology literature using full research articles published within the last 5 years that reported outcomes in pregnant women with SCD. The prevalence of acute pain episodes during pregnancy ranged between 4% and 75%. The prevalence of ACS episodes during pregnancy ranged between 4% and 13%. The estimated prevalence of pulmonary thromboembolism in women with SCD during pregnancy is approximately 0.5 to 1%. ACS is the most common cause of death and is often preceded by acute pain episodes. The most crucial time to develop these complications in pregnancy is during the third trimester and postpartum period. In a pooled analysis from studies in low- and middle-income settings, maternal death in women with SCD is approximately 2393 and 4300 deaths per 100 000 live births with and without multidisciplinary care, respectively. In comparison, in the US and northern Europe, the general maternal mortality rate is approximately 23.8 and 8 deaths per 100 000 live births, respectively. A multidisciplinary SCD obstetrics care approach reduces maternal and perinatal morbidity and mortality in low- and middle-income countries.
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Affiliation(s)
- Eugenia Vicky Asare
- Ghana Institute of Clinical Genetics, Korle-Bu, Accra, Ghana
- Department of Haematology, Korle-Bu Teaching Hospital, Accra, Ghana
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4
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Strunk C, Tartaglione I, Piccone CM, Colombatti R, Andemariam B, Manwani D, Smith A, Haile H, Kim E, Wilson S, Asare EV, Rivers A, Farooq F, Urbonya R, Boruchov D, Boatemaa GD, Perrotta S, Ekem I, Sainati L, Rao S, Zempsky W, Sey F, Antwi-Boasiako C, Segbefia C, Inusa B, Campbell AD. Global geographic differences in healthcare utilization for sickle cell disease pain crises in the CASiRe cohort. Blood Cells Mol Dis 2021; 92:102612. [PMID: 34564050 DOI: 10.1016/j.bcmd.2021.102612] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 09/13/2021] [Accepted: 09/15/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND Sickle cell disease (SCD) is characterized by frequent, unpredictable pain episodes and other vaso-occlusive crises (VOCs) leading to significant healthcare utilization. VOC frequency is often an endpoint in clinical trials investigating novel therapies for this devastating disease. PROCEDURE The Consortium for the Advancement of Sickle Cell Research (CASiRe) is an international collaboration investigating clinical severity in SCD using a validated questionnaire and medical chart review standardized across four countries (United States, United Kingdom, Italy and Ghana). RESULTS This study, focused on pain crisis incidence and healthcare utilization, included 868 patients, equally represented according to age and gender. HgbSS was the most common genotype. Patients from Ghana used the Emergency Room/Day Hospital for pain more frequently (annualized mean 2.01) than patients from other regions (annualized mean 1.56 U.S.; 1.09 U.K.; 0.02 Italy), while U.K. patients were hospitalized for pain more often (annualized mean: U.K. 2.98) than patients in other regions (annualized mean 1.98 U.S.; 1.18 Ghana; Italy 0.54). Italy's hospitalization rate for pain (annualized mean: 0.57) was nearly 20 times greater than its emergency room/day hospital only visits for pain (annualized mean: 0.03). When categorized by genotype and age, similar results were seen. CONCLUSIONS Geographic differences in pain crisis frequency and healthcare utilization may correlate with variable organization of healthcare systems among countries and should be considered regarding trial design, endpoints, and analysis of results when investigating novel agents for clinical benefit.
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Affiliation(s)
- Crawford Strunk
- Department of Pediatric Hematology/Oncology, ProMedica Russell J. Ebeid Children's Hospital, Toledo, OH, USA.
| | - Immacolata Tartaglione
- Department of Women, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Connie M Piccone
- Pediatric Hematology, Carle Foundation Hospital, Urbana, IL, USA
| | - Raffaella Colombatti
- Clinic of Pediatric Hematology Oncology, Department of Women's and Child Health, Azienda Ospedaliera-Università di Padova, Padova, Italy
| | - Biree Andemariam
- New England Sickle Cell Institute, Division of Hematology-Oncology, Neag Comprehensive Cancer Center, UCONN Health, University of Connecticut, Farmington, CT, USA
| | - Deepa Manwani
- Department of Pediatrics, Albert Einstein College of Medicine, Children's Hospital at Montefiore, Bronx, NY, USA
| | - Ashya Smith
- Division of Pediatric Hematology/Oncology, University of Michigan, Ann Arbor, MI, USA
| | - Haikel Haile
- Division of Pediatric Hematology/Oncology, University of Michigan, Ann Arbor, MI, USA
| | - Esther Kim
- Division of Pediatric Hematology/Oncology, University of Michigan, Ann Arbor, MI, USA
| | - Samuel Wilson
- Division of Pediatric Hematology/Oncology, University of Michigan, Ann Arbor, MI, USA
| | - Eugenia Vicky Asare
- Ghana Institute of Clinical Genetics, Korle Bu Teaching Hospital, Accra, Ghana
| | - Angela Rivers
- UCSF Benioff Children's Hospital Oakland, Oakland, CA, USA
| | - Fatimah Farooq
- Division of Pediatric Hematology/Oncology, University of Michigan, Ann Arbor, MI, USA
| | - Rebekah Urbonya
- Division of Pediatric Hematology/Oncology, University of Michigan, Ann Arbor, MI, USA
| | - Donna Boruchov
- Department of Child Health, Korle Bu Teaching Hospital, Accra, Ghana
| | - Gifty Dankwah Boatemaa
- Department of Physiology, University of Ghana Medical School, University of Ghana, Accra, Ghana
| | - Silverio Perrotta
- Department of Women, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Ivy Ekem
- Ghana Institute of Clinical Genetics, Korle Bu Teaching Hospital, Accra, Ghana
| | - Laura Sainati
- Clinic of Pediatric Hematology Oncology, Department of Women's and Child Health, Azienda Ospedaliera-Università di Padova, Padova, Italy
| | - Sudha Rao
- Department of Child Health, Korle Bu Teaching Hospital, Accra, Ghana
| | - William Zempsky
- Division of Pain and Palliative Care, Department of Pediatrics, University of Connecticut School of Medicine, Connecticut Children's Medical Center, Hartford, CT, USA
| | - Fredericka Sey
- Ghana Institute of Clinical Genetics, Korle Bu Teaching Hospital, Accra, Ghana
| | - Charles Antwi-Boasiako
- Department of Physiology, University of Ghana Medical School, University of Ghana, Accra, Ghana; Ghana Institute of Clinical Genetics, Korle Bu Teaching Hospital, Accra, Ghana
| | - Catherine Segbefia
- Department of Child Health, Korle Bu Teaching Hospital, Accra, Ghana; Department of Child Health, University of Ghana Medical School, University of Ghana, Accra, Ghana
| | - Baba Inusa
- Department of Pediatric Haematology, Evelina Children's Hospital, Guy's and St. Thomas NHS Trust, London, UK
| | - Andrew D Campbell
- Division of Pediatric Hematology/Oncology, University of Michigan, Ann Arbor, MI, USA; Department of Pediatrics, Divison of Hematology, Children's National Hospital, George Washington University School of Medicine Health Sciences, Washington, DC, USA
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Hayfron‐Benjamin CF, Asare EV, Boafor T, Olayemi E, Dei‐Adomakoh Y, Musah L, Mensah E, Beyuo T, Kassim AA, Rodeghier M, DeBaun MR, Oppong SA. Low FEV 1 is associated with fetal death in pregnant women with sickle cell disease. Am J Hematol 2021; 96:E303-E306. [PMID: 33984165 DOI: 10.1002/ajh.26236] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 05/08/2021] [Accepted: 05/10/2021] [Indexed: 02/02/2023]
Affiliation(s)
- Charles F. Hayfron‐Benjamin
- Department of Physiology University of Ghana Medical School Accra Ghana
- Department of Anesthesia Korle‐Bu Teaching Hospital Accra Ghana
| | - Eugenia Vicky Asare
- Ghana Institute of Clinical Genetics, Korle‐Bu Accra Ghana
- Department of Hematology Korle‐Bu Teaching Hospital Accra Ghana
| | - Theodore Boafor
- Department of Obstetrics and Gynecology Korle‐Bu Teaching Hospital Accra Ghana
- Department of Obstetrics and Gynecology University of Ghana Medical School Accra Ghana
| | - Edeghonghon Olayemi
- Ghana Institute of Clinical Genetics, Korle‐Bu Accra Ghana
- Department of Hematology University of Ghana Medical School Accra Ghana
| | - Yvonne Dei‐Adomakoh
- Ghana Institute of Clinical Genetics, Korle‐Bu Accra Ghana
- Department of Hematology University of Ghana Medical School Accra Ghana
| | - Latif Musah
- Department of Physiology University of Ghana Medical School Accra Ghana
| | - Enoch Mensah
- Department of Hematology University of Ghana Medical School Accra Ghana
| | - Titus Beyuo
- Department of Obstetrics and Gynecology Korle‐Bu Teaching Hospital Accra Ghana
- Department of Obstetrics and Gynecology University of Ghana Medical School Accra Ghana
| | - Adetola A. Kassim
- Vanderbilt‐Meharry Center of Excellence in Sickle Cell Disease, Vanderbilt University Medical Center Nashville Tennessee USA
| | | | - Michael R. DeBaun
- Vanderbilt‐Meharry Center of Excellence in Sickle Cell Disease, Vanderbilt University Medical Center Nashville Tennessee USA
| | - Samuel A. Oppong
- Department of Obstetrics and Gynecology Korle‐Bu Teaching Hospital Accra Ghana
- Department of Obstetrics and Gynecology University of Ghana Medical School Accra Ghana
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6
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Campbell AD, Colombatti R, Andemariam B, Strunk C, Tartaglione I, Piccone CM, Manwani D, Asare EV, Boruchov D, Farooq F, Urbonya R, Boatemaa GD, Perrotta S, Sainati L, Rivers A, Rao S, Zempsky W, Sey F, Segbefia C, Inusa B, Antwi-Boasiako C. An Analysis of Racial and Ethnic Backgrounds Within the CASiRe International Cohort of Sickle Cell Disease Patients: Implications for Disease Phenotype and Clinical Research. J Racial Ethn Health Disparities 2021; 8:99-106. [PMID: 32418182 PMCID: PMC7669607 DOI: 10.1007/s40615-020-00762-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2020] [Revised: 04/06/2020] [Accepted: 04/13/2020] [Indexed: 12/13/2022]
Abstract
Millions are affected by sickle cell disease (SCD) worldwide with the greatest burden in sub-Saharan Africa. While its origin lies historically within the malaria belt, ongoing changes in migration patterns have shifted the burden of disease resulting in a global public health concern. We created the Consortium for the Advancement of Sickle Cell Research (CASiRe) to understand the different phenotypes of SCD across 4 countries (USA, UK, Italy, and Ghana). Here, we report the multi-generational ethnic and racial background of 877 SCD patients recruited in Ghana (n = 365, 41.6%), the USA (n = 254, 29%), Italy (n = 81, 9.2%), and the UK (n = 177, 20.2%). West Africa (including Benin Gulf) (N = 556, 63.4%) was the most common geographic region of origin, followed by North America (N = 184, 21%), Caribbean (N = 51, 5.8%), Europe (N = 27, 3.1%), Central Africa (N = 24, 2.7%), and West Africa (excluding Benin Gulf) (N = 21, 2.4%). SCD patients in Europe were primarily West African (73%), European (10%), Caribbean (8%), and Central African (8%). In the USA, patients were largely African American (71%), Caribbean (13%), or West African (10%). Most subjects identified themselves as Black or African American; the European cohort had the largest group of Caucasian SCD patients (8%), including 21% of the Italian patients. This is the first report of a comprehensive analysis of ethnicity within an international, transcontinental group of SCD patients. The diverse ethnic backgrounds observed in our cohort raises the possibility that genetic and environmental heterogeneity within each SCD population subgroup can affect the clinical phenotype and research outcomes.
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Affiliation(s)
- Andrew D Campbell
- Division of Pediatric Hematology/Oncology, University of Michigan, Ann Arbor, MI, USA.
- Center for Cancer and Blood Disorders, Children's National Medical Center, Washington, DC, USA.
| | - Raffaella Colombatti
- Clinic of Pediatric Hematology Oncology, Department of Women's and Child Health, Azienda Ospedaliera-Università di Padova, Padova, Italy
| | - Biree Andemariam
- Division of Hematology-Oncology, New England Sickle Cell Institute, Neag Comprehensive Cancer Center, UCONN Health, University of Connecticut, Farmington, CT, USA
| | - Crawford Strunk
- ProMedica Russell J. Ebeid Children's Hospital, Toledo, OH, USA
| | - Immacolata Tartaglione
- Department of Women, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Connie M Piccone
- Pediatric Hematology/Oncology, Rainbow Babies and Children's Hospital, Cleveland, OH, USA
| | - Deepa Manwani
- Department of Pediatrics, Albert Einstein College of Medicine, Children's Hospital at Montefiore, Bronx, NY, USA
| | - Eugenia Vicky Asare
- Ghana Institute of Clinical Genetics, Korle Bu Teaching Hospital, Accra, Ghana
- Department of Hematology, Korle-Bu Teaching Hospital, Accra, Ghana
| | - Donna Boruchov
- Department of Pediatrics, Connecticut Children's Medical Center, Hartford, CT, USA
| | - Fatimah Farooq
- Division of Pediatric Hematology/Oncology, University of Michigan, Ann Arbor, MI, USA
| | - Rebekah Urbonya
- Division of Pediatric Hematology/Oncology, University of Michigan, Ann Arbor, MI, USA
| | | | - Silverio Perrotta
- Department of Women, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Laura Sainati
- Clinic of Pediatric Hematology Oncology, Department of Women's and Child Health, Azienda Ospedaliera-Università di Padova, Padova, Italy
| | - Angela Rivers
- Division of Pediatric Hematology/Oncology, University of Illinois-Chicago, Chicago, IL, USA
| | - Sudha Rao
- Department of Child Health, Korle Bu Teaching Hospital, Accra, Ghana
| | - William Zempsky
- Department of Pediatrics, Connecticut Children's Medical Center, Hartford, CT, USA
| | - Fredericka Sey
- Ghana Institute of Clinical Genetics, Korle Bu Teaching Hospital, Accra, Ghana
| | | | - Baba Inusa
- Department of Pediatric Haematology, Evelina Children's Hospital, Guy's and St. Thomas NHS Trust, London, UK
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7
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Tartaglione I, Strunk C, Antwi-Boasiako C, Andemariam B, Colombatti R, Asare EV, Piccone CM, Manwani D, Boruchov D, Tavernier F, Farooq F, Akatue S, Oteng B, Urbonya R, Wilson S, Owda A, Bamfo R, Boatemaa GD, Rao S, Zempsky W, Sey F, Inusa BP, Perrotta S, Segbefia C, Campbell AD. Age of first pain crisis and associated complications in the CASiRe international sickle cell disease cohort. Blood Cells Mol Dis 2021; 88:102531. [PMID: 33401140 DOI: 10.1016/j.bcmd.2020.102531] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2020] [Revised: 10/18/2020] [Accepted: 12/08/2020] [Indexed: 10/22/2022]
Abstract
Pain is a hallmark of Sickle Cell Disease (SCD) affecting patients throughout their life; the first pain crisis may occur at any age and is often the first presentation of the disease. Universal newborn screening identifies children with SCD at birth, significantly improving morbidity and mortality. Without early screening, diagnosis is generally made after disease manifestations appear. The Consortium for the Advancement of Sickle Cell Research (CASiRe) is an international collaborative group evaluating the clinical severity of subjects with SCD using a validated questionnaire and medical chart review, standardized across 4 countries (United States, United Kingdom, Italy and Ghana). We investigated the age of first pain crisis in 555 sickle cell subjects, 344 adults and 211 children. Median age of the first crisis in the whole group was 4 years old, 5 years old among adults and 2 years old among children. Patients from the United States generally reported the first crisis earlier than Ghanaians. Experiencing the first pain crisis early in life correlated with the genotype and disease severity. Early recognition of the first pain crisis could be useful to guide counseling and management of the disease.
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Affiliation(s)
- Immacolata Tartaglione
- Department of Women, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Crawford Strunk
- ProMedica Russell J. Ebeid Children's Hospital, Toledo, OH, USA
| | - Charles Antwi-Boasiako
- Department of Physiology, University of Ghana Medical School, University of Ghana, Accra, Ghana
| | - Biree Andemariam
- New England Sickle Cell Institute, Division of Hematology-Oncology, Neag Comprehensive Cancer Center, UCONN Health, University of Connecticut, Farmington, CT, USA
| | - Raffaella Colombatti
- Clinic of Pediatric Hematology Oncology, Department of Women's and Child Health, Azienda Ospedaliera-Università di Padova, Padova, Italy
| | | | - Connie M Piccone
- Pediatric Hematology/Oncology, Rainbow Babies and Children's Hospital, Cleveland, OH, USA
| | - Deepa Manwani
- Department of Pediatrics, Albert Einstein College of Medicine, Children's Hospital at Montefiore, Bronx, NY, USA
| | - Donna Boruchov
- Department of Pediatrics, University of Connecticut School of Medicine, Connecticut Children's Medical Center, Hartford, CT, USA
| | - Fitz Tavernier
- Division of Pediatric Hematology/Oncology, University of Michigan, Ann Arbor, MI, USA
| | - Fatimah Farooq
- Division of Pediatric Hematology/Oncology, University of Michigan, Ann Arbor, MI, USA
| | - Sophia Akatue
- Division of Pediatric Hematology/Oncology, University of Michigan, Ann Arbor, MI, USA
| | - Bianca Oteng
- Division of Pediatric Hematology/Oncology, University of Michigan, Ann Arbor, MI, USA
| | - Rebekah Urbonya
- Division of Pediatric Hematology/Oncology, University of Michigan, Ann Arbor, MI, USA
| | - Samuel Wilson
- Division of Pediatric Hematology/Oncology, University of Michigan, Ann Arbor, MI, USA
| | - Ahmed Owda
- Division of Pediatric Hematology/Oncology, University of Michigan, Ann Arbor, MI, USA
| | - Rose Bamfo
- Division of Pediatric Hematology/Oncology, University of Michigan, Ann Arbor, MI, USA
| | - Gifty Dankwah Boatemaa
- Department of Physiology, University of Ghana Medical School, University of Ghana, Accra, Ghana
| | - Sudha Rao
- Department of Child Health, University of Ghana Medical School Accra, Ghana
| | - William Zempsky
- Department of Pediatrics, University of Connecticut School of Medicine, Connecticut Children's Medical Center, Hartford, CT, USA
| | - Fredericka Sey
- Ghana Institute of Clinical Genetics, Korle Bu Teaching Hospital, Accra, Ghana
| | - Baba Pd Inusa
- Department of Pediatric Haematology, Evelina Children's Hospital, Guy's and St. Thomas NHS Trust, London, UK
| | - Silverio Perrotta
- Department of Women, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Catherine Segbefia
- Department of Child Health, University of Ghana Medical School Accra, Ghana
| | - Andrew D Campbell
- Division of Pediatric Hematology/Oncology, University of Michigan, Ann Arbor, MI, USA; Center for Cancer and Blood Disorders, Children's National Medical Center; George Washington University School of Medicine Health Sciences, Washington, DC, USA.
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8
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Asare EV, Olayemi E, Boafor T, Dei‐Adomakoh Y, Mensah Dip E, Benjamin CH, Covert B, Kassim AA, James A, Rodeghier M, DeBaun MR, Oppong SA. Third trimester and early postpartum period of pregnancy have the greatest risk for ACS in women with SCD. Am J Hematol 2019; 94:E328-E331. [PMID: 31571271 DOI: 10.1002/ajh.25643] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Accepted: 09/16/2019] [Indexed: 11/09/2022]
Affiliation(s)
- Eugenia Vicky Asare
- Ghana Institute of Clinical Genetics Korle Bu Teaching Hospital Accra Ghana
- Department of Hematology Korle Bu Teaching Hospital Accra Ghana
| | - Edeghonghon Olayemi
- Ghana Institute of Clinical Genetics Korle Bu Teaching Hospital Accra Ghana
- Department of Hematology University of Ghana Medical School Accra Ghana
| | - Theodore Boafor
- Department of Obstetrics and Gynecology Korle Bu Teaching Hospital Accra Ghana
- Department of Obstetrics and Gynecology University of Ghana Medical School Accra Ghana
| | - Yvonne Dei‐Adomakoh
- Ghana Institute of Clinical Genetics Korle Bu Teaching Hospital Accra Ghana
- Department of Hematology University of Ghana Medical School Accra Ghana
| | - Enoch Mensah Dip
- Department of Hematology University of Ghana Medical School Accra Ghana
| | - Charles Hayfron Benjamin
- Department of Physiology University of Ghana Medical School Accra Ghana
- Department of Anesthesia Korle Bu Teaching Hospital Accra Ghana
| | - Brittany Covert
- Vanderbilt‐Meharry, Center of Excellence in Sickle Cell Disease Vanderbilt University Medical Center Nashville Tennessee
| | - Adetola A. Kassim
- Vanderbilt‐Meharry, Center of Excellence in Sickle Cell Disease Vanderbilt University Medical Center Nashville Tennessee
| | | | | | - Michael R. DeBaun
- Vanderbilt‐Meharry, Center of Excellence in Sickle Cell Disease Vanderbilt University Medical Center Nashville Tennessee
| | - Samuel A. Oppong
- Department of Obstetrics and Gynecology Korle Bu Teaching Hospital Accra Ghana
- Department of Obstetrics and Gynecology University of Ghana Medical School Accra Ghana
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9
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Asare EV, Olayemi E, Boafor T, Dei-Adomakoh Y, Mensah E, Osei-Bonsu Y, Crabbe S, Musah L, Hayfron-Benjamin C, Covert-Greene B, Kassim AA, James A, Rodeghier M, DeBaun MR, Oppong SA. A case series describing causes of death in pregnant women with sickle cell disease in a low-resource setting. Am J Hematol 2018; 93:E167-E170. [PMID: 29659044 DOI: 10.1002/ajh.25115] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2018] [Revised: 04/07/2018] [Accepted: 04/10/2018] [Indexed: 11/09/2022]
Affiliation(s)
- Eugenia Vicky Asare
- Ghana Institute of Clinical Genetics, Korle- Bu; Accra Ghana
- Department of Hematology; Korle-Bu Teaching Hospital; Accra Ghana
| | - Edeghonghon Olayemi
- Ghana Institute of Clinical Genetics, Korle- Bu; Accra Ghana
- Department of Hematology, College of Health Sciences; University of Ghana; Accra Ghana
| | - Theodore Boafor
- Department of Obstetrics and Gynecology; Korle-Bu Teaching Hospital; Accra Ghana
| | - Yvonne Dei-Adomakoh
- Ghana Institute of Clinical Genetics, Korle- Bu; Accra Ghana
- Department of Hematology, College of Health Sciences; University of Ghana; Accra Ghana
| | - Enoch Mensah
- Department of Hematology, College of Health Sciences; University of Ghana; Accra Ghana
| | | | - Selina Crabbe
- Ghana Institute of Clinical Genetics, Korle- Bu; Accra Ghana
| | - Latif Musah
- Department of Physiology, School of Biomedical and Allied Health Sciences; University of Ghana; Accra Ghana
| | - Charles Hayfron-Benjamin
- Department of Physiology, School of Biomedical and Allied Health Sciences; University of Ghana; Accra Ghana
- Department of Anesthesia; Korle-Bu Teaching Hospital; Accra Ghana
| | - Brittany Covert-Greene
- Vanderbilt-Meharry Center of Excellence in Sickle Cell Disease, Vanderbilt University Medical Center; Nashville
| | - Adetola A. Kassim
- Vanderbilt-Meharry Center of Excellence in Sickle Cell Disease, Vanderbilt University Medical Center; Nashville
| | | | | | - Michael R. DeBaun
- Vanderbilt-Meharry Center of Excellence in Sickle Cell Disease, Vanderbilt University Medical Center; Nashville
| | - Samuel A. Oppong
- Department of Obstetrics and Gynecology; Korle-Bu Teaching Hospital; Accra Ghana
- Department of Obstetrics and Gynecology; School of Medicine and Dentistry, University of Ghana; Accra Ghana
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10
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Asare EV, Olayemi E, Boafor T, Dei-Adomakoh Y, Mensah E, Ghansah H, Osei-Bonsu Y, Crabbe S, Musah L, Hayfron-Benjamin C, Covert B, Kassim AA, James A, Rodeghier M, DeBaun MR, Oppong SA. Implementation of multidisciplinary care reduces maternal mortality in women with sickle cell disease living in low-resource setting. Am J Hematol 2017; 92:872-878. [PMID: 28512745 DOI: 10.1002/ajh.24790] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2017] [Revised: 05/10/2017] [Accepted: 05/11/2017] [Indexed: 11/12/2022]
Abstract
Sickle cell disease (SCD) is associated with adverse pregnancy outcome. In women with SCD living in low-resource settings, pregnancy is associated with significantly increased maternal and perinatal mortality rates. We tested the hypothesis that implementing a multidisciplinary obstetric and hematology care team in a low-resource setting would significantly reduce maternal and perinatal mortality rates. We conducted a before-and-after study, at the Korle-Bu Teaching Hospital in Accra, Ghana, to evaluate the effect of a multidisciplinary obstetric-hematology care team for women with SCD in a combined SCD-Obstetric Clinic. The pre-intervention period was assessed through a retrospective chart review to identify every death and the post-intervention period was assessed prospectively. Interventions consisted of joint obstetrician and hematologist outpatient and acute inpatient reviews, close maternal and fetal surveillance, and simple protocols for management of acute chest syndrome and acute pain episodes. Primary outcomes included maternal and perinatal mortality rates before and after the study period. A total of 158 and 90 pregnant women with SCD were evaluated in the pre- and post- intervention periods, respectively. The maternal mortality rate decreased from 10 791 per 100 000 live births at pre-intervention to 1176 per 100 000 at post-intervention, representing a risk reduction of 89.1% (P = 0.007). Perinatal mortality decreased from 60.8 per 1000 total births at pre-intervention to 23.0 per 1000 at post-intervention, representing a risk reduction of 62.2% (P = 0.20). A multidisciplinary obstetric and hematology team approach can dramatically reduce maternal and perinatal mortality in a low-resource setting.
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Affiliation(s)
- Eugenia Vicky Asare
- Ghana Institute of Clinical Genetics; Korle-Bu Accra Ghana
- Department of Hematology, College of Health Sciences; University of Ghana; Accra Ghana
| | - Edeghonghon Olayemi
- Ghana Institute of Clinical Genetics; Korle-Bu Accra Ghana
- Department of Hematology, College of Health Sciences; University of Ghana; Accra Ghana
| | - Theodore Boafor
- Department of Obstetrics and Gynecology; Korle-Bu Teaching Hospital; Accra Ghana
| | - Yvonne Dei-Adomakoh
- Department of Hematology, College of Health Sciences; University of Ghana; Accra Ghana
| | - Enoch Mensah
- Department of Hematology, College of Health Sciences; University of Ghana; Accra Ghana
| | - Harriet Ghansah
- Department of Hematology, College of Health Sciences; University of Ghana; Accra Ghana
| | | | - Selina Crabbe
- Ghana Institute of Clinical Genetics; Korle-Bu Accra Ghana
| | - Latif Musah
- Department of Physiology, School of Biomedical and Allied Health Sciences; University of Ghana; Accra Ghana
| | - Charles Hayfron-Benjamin
- Department of Physiology, School of Biomedical and Allied Health Sciences; University of Ghana; Accra Ghana
- Department of Anesthesia; Korle-Bu Teaching Hospital; Accra Ghana
| | - Brittany Covert
- Vanderbilt-Meharry Center of Excellence in Sickle Cell Disease, Vanderbilt University Medical Center; Nashville Tennessee
| | - Adetola A. Kassim
- Vanderbilt-Meharry Center of Excellence in Sickle Cell Disease, Vanderbilt University Medical Center; Nashville Tennessee
| | | | | | - Michael R. DeBaun
- Vanderbilt-Meharry Center of Excellence in Sickle Cell Disease, Vanderbilt University Medical Center; Nashville Tennessee
| | - Samuel A. Oppong
- Department of Obstetrics and Gynecology; Korle-Bu Teaching Hospital; Accra Ghana
- Department of Obstetrics and Gynecology, School of Medicine and Dentistry; University of Ghana; Accra Ghana
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