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Ranque B, Kitenge R, Ndiaye DD, Ba MD, Adjoumani L, Traore H, Coulibaly C, Guindo A, Boidy K, Mbuyi D, Ly ID, Offredo L, Diallo DA, Tolo A, Kafando E, Tshilolo L, Diagne I. Estimating the risk of child mortality attributable to sickle cell anaemia in sub-Saharan Africa: a retrospective, multicentre, case-control study. The Lancet Haematology 2022; 9:e208-e216. [DOI: 10.1016/s2352-3026(22)00004-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 01/03/2022] [Accepted: 01/05/2022] [Indexed: 12/13/2022]
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2
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Jaquet A, Boni SP, Boidy K, Tine J, Tchounga B, Touré SA, Koffi JJ, Dial C, Monnereau A, Diomande I, Tanon A, Seydi M, Dabis F, Diop S, Koffi G. Chronic viral hepatitis, HIV infection and Non-Hodgkin lymphomas in West Africa, a case-control study. Int J Cancer 2021; 149:1536-1543. [PMID: 34124779 DOI: 10.1002/ijc.33709] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Revised: 05/17/2021] [Accepted: 05/28/2021] [Indexed: 12/09/2022]
Abstract
Non-Hodgkin lymphomas (NHL) are underestimated causes of cancer in West Africa where chronic viral hepatitis and HIV are endemic. While the association with HIV infection has already been characterized, limited information is available on the association between chronic viral hepatitis and NHL in sub-Saharan Africa. A case-control study was conducted in referral hospitals of Abidjan (Cote d'Ivoire) and Dakar (Senegal). Cases of NHL were matched with controls on age, gender and participating site. The diagnosis of NHL relied on local pathological examination completed with immunohistochemistry. HIV, HBV and HCV serology tests were systematically performed. A conditional logistic regression model estimated the associations by the Odds Ratio (OR) with their 95% confidence interval (CI). A total of 117 NHL cases (Abidjan n = 97, Dakar n = 20) and their 234 matched controls were enrolled. Cases were predominantly men (68.4%) and had a median age of 50 years (IQR 37-57). While Diffuse Large B-cell lymphoma were the most reported morphological type (n = 35) among mature B-cell NHL, the proportion mature T-cell NHL (30%) was high. The prevalence figures of HBV, HCV and HIV infection were 12.8%, 7.7% and 14.5%, respectively among cases of NHL. In multivariate analysis, HBV, HCV and HIV were independently associated with NHL with OR of 2.23 (CI 1.05-4.75), 4.82 (CI 1.52-15.29) and 3.32 (CI 1.54-7.16), respectively. Chronic viral hepatitis B and C were significantly associated with NHL in West Africa. Timely preventive measures against HBV infection and access to curative anti-HCV treatment might prevent a significant number of NHL.
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Affiliation(s)
- Antoine Jaquet
- University of Bordeaux, Inserm, French National Research Institute for Sustainable Development (IRD), Bordeaux, France
| | - Simon P Boni
- Programme National de Lutte Contre le Cancer (PNLCa), Abidjan, Côte d'Ivoire.,Programme PACCI/Site ANRS Abidjan, Abidjan, Côte d'Ivoire
| | - Kouakou Boidy
- Service d'hématologie, Centre Hospitalier Universitaire de Yopougon, Abidjan, Côte d'Ivoire
| | - Judicaël Tine
- Service des Maladies Infectieuses et Tropicales, Centre Hospitalier National Universitaire de Fann, Dakar, Senegal
| | - Boris Tchounga
- Programme PACCI/Site ANRS Abidjan, Abidjan, Côte d'Ivoire.,Elizabeth Glaser Pediatric AIDS Foundation, Yaoundé, Cameroon
| | - Sokhna A Touré
- Service d'hématologie, Centre National de Transfusion Sanguine, Dakar, Senegal
| | | | - Cherif Dial
- Service Anatomopathologie, Hôpital de Grand Yoff, Dakar, Senegal
| | - Alain Monnereau
- University of Bordeaux, Inserm, French National Research Institute for Sustainable Development (IRD), Bordeaux, France
| | - Isidore Diomande
- Service Anatomopathologie, Centre Hospitalier Universitaire Cocody, Abidjan, Côte d'Ivoire
| | - Aristophane Tanon
- Service des Maladies Infectieuses et Tropicales, Centre Hospitalier Universitaire de Treichville, Abidjan, Côte d'Ivoire
| | - Moussa Seydi
- Service des Maladies Infectieuses et Tropicales, Centre Hospitalier National Universitaire de Fann, Dakar, Senegal
| | - François Dabis
- University of Bordeaux, Inserm, French National Research Institute for Sustainable Development (IRD), Bordeaux, France
| | - Saliou Diop
- Service d'hématologie, Centre National de Transfusion Sanguine, Dakar, Senegal
| | - Gustave Koffi
- Service d'hématologie, Centre Hospitalier Universitaire de Yopougon, Abidjan, Côte d'Ivoire
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Diby FK, Adoubi AK, Esse-Diby MCA, Gnaba AL, Zadi SZ, Ouattara AEP, N'Guessan KE, Boidy K, Azagoh-Kouadio R, Nanan I, Doumbia M, Kpon R, Ayegnon KG, Meneas CG, Diomande M, Sall F, Koffi MN, Coulibaly A, Ehui EA, Yao KM, Yapo JM, Ehua SF, Yangni-Angate HK, Simon P, Moulin T. A Medico-Socio-Economic Analysis of TeleEKG in Ivory Coast. Telemed J E Health 2020; 27:286-295. [PMID: 32907516 DOI: 10.1089/tmj.2020.0075] [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] [Indexed: 11/12/2022] Open
Abstract
Background: TeleEKG is gradually being integrated into the care offered to the most isolated Ivorian populations, however, no medico-socio-economic analysis of its impact has yet been conducted. Introduction: The aim of this study was to assess the medico-socio-economic impact of a teleEKG network in the provision of cardiology care in Ivory Coast. Methods: A retrospective study of the data transmitted by the 10 centers involved in the pilot phase of the teleEKG project from January 2015 to December 2017. Results: The average ratio between the cost to the patient of performing an electrocardiogram (EKG) according to the traditional practice and using a teleEKG was 3.8 ± 1.64. The distance avoided by the 6,045 patients was 1,074,090 km (average 177.7 km/patient). The 6,045 teleEKGs carried out over the period of the study produced a total revenue of 36,270,000 XOF (55,290 EUR) or an average revenue per site of 3,627,000 XOF (5,529 EUR). Dyspnea on exertion (22%), and hypertension (21%) were the main indications for performing the EKG, and left ventricular hypertrophy was the most common electrical anomaly detected (19.8%). Acute coronary syndrome with persistent ST segment elevation was diagnosed in 0.7% of cases (40 cases) and atrial fibrillation in 1.12% of cases (68 cases). Discussion: These results confirm the key role telemedicine can play in the treatment of heart conditions in rural populations and the economic sustainability of such telemedicine networks. Conclusions: teleEKG offers economic accessibility to cardiology care for isolated populations in Ivory Coast.
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Affiliation(s)
- Florent Kouakou Diby
- Department of Cardiovascular and Thoracic Diseases of Bouaké Teaching University Hospital, Côte d'Ivoire
| | - Anicet Kassi Adoubi
- Department of Cardiovascular and Thoracic Diseases of Bouaké Teaching University Hospital, Côte d'Ivoire
| | | | - Ambroise Loa Gnaba
- Department of Cardiovascular and Thoracic Diseases of Bouaké Teaching University Hospital, Côte d'Ivoire
| | - Serge Zadi Zadi
- Department of Ethnosociology Alassane Ouattara University of Bouaké, Bouaké, Côte d'Ivoire
| | | | | | - Kouakou Boidy
- Hematology Department of Yopougon University Hospital, Yopougon, Côte d'Ivoire
| | | | - Innocent Nanan
- Francophone Africa Telemedicine Network and the Ivorian Society of Biosciences and Medical Informatics Abidjan, Côte d'Ivoire
| | - Mamadou Doumbia
- Francophone Africa Telemedicine Network and the Ivorian Society of Biosciences and Medical Informatics Abidjan, Côte d'Ivoire
| | - Roger Kpon
- Francophone Africa Telemedicine Network and the Ivorian Society of Biosciences and Medical Informatics Abidjan, Côte d'Ivoire.,Department of Swiss Center for Scientific Research, Abidjan, Côte d'Ivoire
| | - Kouakou Grégoire Ayegnon
- Department of Cardiovascular and Thoracic Diseases of Bouaké Teaching University Hospital, Côte d'Ivoire
| | - Christophe Gueu Meneas
- Department of Cardiovascular and Thoracic Diseases of Bouaké Teaching University Hospital, Côte d'Ivoire
| | - Manga Diomande
- Department of Cardiovascular and Thoracic Diseases of Bouaké Teaching University Hospital, Côte d'Ivoire
| | - Fatouma Sall
- Department of Cardiovascular and Thoracic Diseases of Bouaké Teaching University Hospital, Côte d'Ivoire
| | - Marie-Nina Koffi
- Department of Cardiovascular and Thoracic Diseases of Bouaké Teaching University Hospital, Côte d'Ivoire
| | - Abdoulaye Coulibaly
- Department of Cardiovascular and Thoracic Diseases of Bouaké Teaching University Hospital, Côte d'Ivoire
| | | | | | | | - Somian Francis Ehua
- Francophone Africa Telemedicine Network and the Ivorian Society of Biosciences and Medical Informatics Abidjan, Côte d'Ivoire
| | - Hervé Koffi Yangni-Angate
- Department of Cardiovascular and Thoracic Diseases of Bouaké Teaching University Hospital, Côte d'Ivoire
| | - Pierre Simon
- Administrative Department of French Telemedicine Society (SFTelemed), Paris, France
| | - Thierry Moulin
- Administrative Department of French Telemedicine Society (SFTelemed), Paris, France.,Neurology Department of University Hospital of Besançon, Besançon, France
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Koffi KG, Silué DA, Laurent C, Boidy K, Koui S, Compaci G, Adeba ZH, Kamara I, Botty RP, Bognini AS, Sanogo I, Despas F, Laurent G. AMAFRICA, a patient-navigator program for accompanying lymphoma patients during chemotherapy in Ivory Coast: a prospective randomized study. BMC Cancer 2019; 19:1247. [PMID: 31870438 PMCID: PMC6929302 DOI: 10.1186/s12885-019-6478-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Accepted: 12/17/2019] [Indexed: 01/08/2023] Open
Abstract
Background Previous studies have indicated that accompanying socially underserved cancer patients through Patient Navigator (PN) or PN-derived procedures improves therapy management and reassurance. At the Cancer Institute of Toulouse-Oncopole (France), we have implemented AMA (Ambulatory Medical Assistance), a PN-based procedure adapted for malignant lymphoma (ML) patients under therapy. We found that AMA improves adherence to chemotherapy and safety. In low-middle income countries (LMIC), refusal and abandonment were documented as major adverse factors for cancer therapy. We reasoned that AMA could improve clinical management of ML patients in LMIC. Methods This study was set up in the Abidjan University Medical Center (Ivory Coast) in collaboration with Toulouse. One hundred African patients were randomly assigned to either an AMA or control group. Main criteria of judgment were refusal and abandonment of CHOP or ABVD chemotherapy. Results We found that AMA was feasible and had significant impact on refusal and abandonment. However, only one third of patients completed their therapy in both groups. No differences were noted in terms of complete response rate (CR) (16% based on intent-to-treat) and median overall survival (OS) (6 months). The main reason for refusal and abandonment was limitation of financial resources. Conclusion Altogether, this study showed that PN may reduce refusal and abandonment of treatment. However, due to insufficient health care coverage, its ultimate impact on OS remains limited.
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Affiliation(s)
- K G Koffi
- Hematology Teaching Hospital of Yopougon University Medical Center, Abidjan, Côte d'Ivoire.
| | - D A Silué
- Hematology Teaching Hospital of Yopougon University Medical Center, Abidjan, Côte d'Ivoire
| | - C Laurent
- Hematology Department of Toulouse University Medical Center, Toulouse, France
| | - K Boidy
- Hematology Teaching Hospital of Yopougon University Medical Center, Abidjan, Côte d'Ivoire
| | - S Koui
- Hematology Teaching Hospital of Yopougon University Medical Center, Abidjan, Côte d'Ivoire
| | - G Compaci
- Hematology Department of Toulouse University Medical Center, Toulouse, France
| | - Z H Adeba
- Hematology Teaching Hospital of Yopougon University Medical Center, Abidjan, Côte d'Ivoire
| | - I Kamara
- Hematology Teaching Hospital of Yopougon University Medical Center, Abidjan, Côte d'Ivoire
| | - R P Botty
- Hematology Teaching Hospital of Yopougon University Medical Center, Abidjan, Côte d'Ivoire
| | - A S Bognini
- Hematology Teaching Hospital of Yopougon University Medical Center, Abidjan, Côte d'Ivoire
| | - I Sanogo
- Hematology Teaching Hospital of Yopougon University Medical Center, Abidjan, Côte d'Ivoire
| | - F Despas
- Hematology Department of Toulouse University Medical Center, Toulouse, France
| | - G Laurent
- Hematology Department of Toulouse University Medical Center, Toulouse, France
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Menet A, Ranque B, Diop IB, Kingue S, N'guetta R, Diarra M, Diallo D, Diop S, Diagne I, Sanogo I, Chelo D, Wamba G, Deme-Ly I, Faye BF, Seck M, Tolo A, Boidy K, Koffi G, Abough EC, Diakite CO, Traore Y, Legueun G, Kamara I, Offredo L, Marechaux S, Mirabel M, Jouven X. Subclinical Cardiac Dysfunction Is Associated With Extracardiac Organ Damages. Front Med (Lausanne) 2018; 5:323. [PMID: 30525039 PMCID: PMC6262341 DOI: 10.3389/fmed.2018.00323] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2018] [Accepted: 10/31/2018] [Indexed: 12/02/2022] Open
Abstract
Background: Several studies conducted in America or Europe have described major cardiac remodeling and diastolic dysfunction in patients with sickle cell disease (SCD). We aimed at assessing cardiac involvement in SCD in sub-Saharan Africa where SCD is the most prevalent. Methods: In Cameroon, Mali and Senegal, SCD patients and healthy controls of the CADRE study underwent transthoracic echocardiography if aged ≥10 years. The comparison of clinical and echocardiographic features between patients and controls, and the associations between echocardiographic features and the vascular complications of SCD were assessed. Results: 612 SCD patients (483 SS or Sβ0, 99 SC, and 19 Sβ+) and 149 controls were included. The prevalence of dyspnea and congestive heart failure was low and did not differ significantly between patients and controls. While left ventricular ejection fraction did not differ between controls and patients, left and right cardiac chambers were homogeneously more dilated and hypertrophic in patients compared to controls and systemic vascular resistances were lower (p < 0.001 for all comparisons). Three hundred and forty nine SCD patients had extra-cardiac organ damages (stroke, leg ulcer, priapism, microalbuminuria or osteonecrosis). Increased left ventricular mass index, cardiac dilatation, cardiac output, and decreased systemic vascular resistances were associated with a history of at least one SCD-related organ damage after adjustment for confounders. Conclusions: Cardiac dilatation, cardiac output, left ventricular hypertrophy, and systemic vascular resistance are associated with extracardiac SCD complications in patients from sub-Saharan Africa despite a low prevalence of clinical heart failure. The prognostic value of cardiac subclinical involvement in SCD patients deserves further studies.
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Affiliation(s)
- Aymeric Menet
- Cardiology unit, Groupement des Hôpitaux de L'université Catholique de Lille, Université Catholique de Lille, Lille, France
| | - Brigitte Ranque
- Internal Medicine Unit, Hôpital Européen Georges Pompidou, Assistance Publique des Hôpitaux de Paris and UMR_S970, Universite Paris Descartes, Inserm, Paris, France
| | | | | | | | - Mamadou Diarra
- Cardiology Unit, Centre Gynéco-obstétrique, Bamako, Mali
| | - Dapa Diallo
- Centre de Recherche et Lutte contre la Drépanocytose, Bamako, Mali
| | - Saliou Diop
- Centre National de Transfusion Sanguine, Dakar, Senegal
| | - Ibrahima Diagne
- Pediatrics Unit, Centre Hospitalier National d'Enfants Albert Royer de Dakar, Université Cheikh Anta Diop, Dakar, Senegal
| | | | - David Chelo
- Cardiology Unit, Fondation Mère Enfant Chantal Biya, Yaoundé, Cameroon
| | - Guillaume Wamba
- Pediatrics Unit, Centre Hospitalier d'Essos, Yaoundé, Cameroon
| | - Indou Deme-Ly
- Pediatrics Unit, Centre Hospitalier National d'Enfants Albert Royer de Dakar, Université Cheikh Anta Diop, Dakar, Senegal
| | | | - Moussa Seck
- Centre National de Transfusion Sanguine, Dakar, Senegal
| | - Aissata Tolo
- Hematology Unit, CHU de Yopougon, Abidjan, Ivory Coast
| | - Kouakou Boidy
- Hematology Unit, CHU de Yopougon, Abidjan, Ivory Coast
| | - Gustave Koffi
- Hematology Unit, CHU de Yopougon, Abidjan, Ivory Coast
| | | | | | - Youssouf Traore
- Centre de Recherche et Lutte contre la Drépanocytose, Bamako, Mali
| | | | - Ismael Kamara
- Hematology Unit, CHU de Yopougon, Abidjan, Ivory Coast
| | - Lucile Offredo
- UMR_S970, Université Paris Descartes, Inserm, Paris, France
| | - Sylvestre Marechaux
- Cardiology unit, Groupement des Hôpitaux de L'université Catholique de Lille, Université Catholique de Lille, Lille, France
| | - Mariana Mirabel
- Cardiology Department, Hôpital Européen Georges Pompidou, Assistance Publique des Hôpitaux de Paris and UMR_S970, Université Paris Descartes, Inserm, Paris, France
| | - Xavier Jouven
- Cardiology Department, Hôpital Européen Georges Pompidou, Assistance Publique des Hôpitaux de Paris and UMR_S970, Université Paris Descartes, Inserm, Paris, France
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Alexandre-Heymann L, Dubert M, Diallo DA, Diop S, Tolo A, Belinga S, Sanogo I, Diagne I, Wamba G, Boidy K, Ly ID, Kamara I, Traore Y, Offredo L, Jouven X, Ranque B. Prevalence and correlates of growth failure in young African patients with sickle cell disease. Br J Haematol 2018; 184:253-262. [PMID: 30467843 DOI: 10.1111/bjh.15638] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [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: 05/22/2018] [Accepted: 09/06/2018] [Indexed: 11/30/2022]
Abstract
Growth failure (GF) in children with sickle cell disease (SCD) tends to decline in high-income countries, but data are lacking in sub-Saharan Africa. We performed a cross-sectional study nested in the CADRE (Cœur, Artères et DREpanocytose) cohort in Mali, Senegal, Cameroon, Gabon and the Ivory Coast. SCD patients and healthy controls aged 5-21 years old were recruited (n = 2583). Frequency of GF, defined as a height, weight or body mass index below the 5th percentile on World health Organization growth charts, was calculated. We assessed associations between GF and SCD phenotypic group, clinical and biological characteristics and history of SCD-related complications. GF was diagnosed in 51% of HbSS, 58% of HbSβ0 , 44% of HbSC, 38% of HbSβ+ patients and 32% of controls. GF in patients was positively associated with parents' lower education level, male sex, age 12-14 years, lower blood pressure, HbSS or HbSβ0 phenotypes, icterus, lower haemoglobin level, higher leucocyte count and microalbuminuria. No association was found between GF and clinical SCD-related complications. In sub-Saharan Africa, GF is still frequent in children with SCD, especially in males and during adolescence. GF is associated with haemolysis and microalbuminuria, but not with the history of SCD-related clinical complications.
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Affiliation(s)
- Laure Alexandre-Heymann
- Internal Medicine Unit, Hôpital Européen Georges Pompidou, Assistance Publique des Hôpitaux de Paris, Paris, France
| | - Marie Dubert
- Internal Medicine Unit, Hôpital Européen Georges Pompidou, Assistance Publique des Hôpitaux de Paris, Paris, France.,UMR_S970, Université Paris Descartes, Inserm, Paris, France
| | - Dapa A Diallo
- Centre de Recherche et Lutte contre la Drépanocytose, Bamako, Mali
| | - Saliou Diop
- Centre National de Transfusion Sanguine, Dakar, Senegal
| | - Aissata Tolo
- Haematology Unit, CHU de Yopougon, Abidjan, Ivory Coast
| | | | | | | | - Guillaume Wamba
- Pediatrics Unit, Centre Hospitalier d'Essos, Yaoundé, Cameroon
| | - Kouakou Boidy
- Centre National de Transfusion Sanguine, Dakar, Senegal
| | | | - Ismaël Kamara
- Centre National de Transfusion Sanguine, Dakar, Senegal
| | | | - Lucile Offredo
- UMR_S970, Université Paris Descartes, Inserm, Paris, France
| | - Xavier Jouven
- UMR_S970, Université Paris Descartes, Inserm, Paris, France.,Cardiology Unit, Hôpital Européen Georges Pompidou, Assistance Publique des Hôpitaux de Paris, Paris, France
| | - Brigitte Ranque
- Internal Medicine Unit, Hôpital Européen Georges Pompidou, Assistance Publique des Hôpitaux de Paris, Paris, France.,UMR_S970, Université Paris Descartes, Inserm, Paris, France
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7
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Ranque B, Menet A, Diop IB, Thiam MM, Diallo D, Diop S, Diagne I, Sanogo I, Kingue S, Chelo D, Wamba G, Diarra M, Anzouan JB, N'Guetta R, Diakite CO, Traore Y, Legueun G, Deme-Ly I, Belinga S, Boidy K, Kamara I, Tharaux PL, Jouven X. Early renal damage in patients with sickle cell disease in sub-Saharan Africa: a multinational, prospective, cross-sectional study. Lancet Haematol 2014; 1:e64-73. [PMID: 27030156 DOI: 10.1016/s2352-3026(14)00007-6] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Chronic kidney disease is one of the leading causes of mortality in patients with sickle cell disease. However, it has been almost exclusively studied in patients with the SS phenotype and in high-income countries, despite more than 80% of patients living in Africa. We looked for the determinants of glomerulopathy in a multinational cohort of patients with sickle cell disease of different phenotypes in sub-Saharan Africa. METHODS In the CADRE cohort, we prospectively included patients 3 years and older with sickle cell disease of all haemoglobin phenotypes in Cameroon, Côte d'Ivoire, Mali, and Senegal. All individuals were assessed at steady state. The main outcome of interest was albuminuria defined as a urine albumin-to-creatinine ratio of greater than 30 mg/g. We investigated the clinical and biological determinants (including haemolysis markers) of albuminuria in two main phenotype groups (SS and Sβ(0); SC and Sβ(+)) with further stratification by age and country. FINDINGS The study is ongoing because of follow-up. 2582 patients with sickle cell disease were included (1776 SS, 136 Sβ(0), 511 SC, and 159 Sβ(+)). 644 patients with the SS and Sβ(0) phenotypes (33·7%, 95% CI 31·6-35·8) and 110 with the SC and Sβ(+) phenotypes (16·4%, 13·6-19·2) had albuminuria. In the SS and Sβ(0) group, albuminuria was detected in 144 (27%) of 527 children younger than 10 years and its frequency increased with age (29 [48%] of 60 patients aged >40 years). Multivariable analysis showed that albuminuria was associated with age (odds ratio 1·43, 95% CI 1·20-1·71; p<0·0001), female sex (1·35, 1·02-1·82; p=0·045), low haemoglobin (0·79, 0·66-0·93; p=0·006), high lactate dehydrogenase concentrations (1·33, 1·14-1·58; p=0·0009), and, using Côte d'Ivoire as the reference, Mali (2·49, 1·64-3·79; p=0·042) and Cameroon (1·59, 1·01-2·51; p=0·0007) in patients with the SS and Sβ(0) phenotypes. The magnitude of the association of albuminuria with haemoglobin and lactate dehydrogenase concentrations increased with age. In the SC and Sβ(+) patients, only low haemoglobin (0·69, 0·48-0·97; p=0·029), high blood pressure (1·63, 1·17-2·27; p=0·0017), and Mali (3·75, 1·75-8·04; p<0·0001) were associated with albuminuria. INTERPRETATION Hyperhaemolysis is associated with albuminuria, with an age-dependent effect, in the SS and Sβ(0) phenotypes only, suggesting a different pathological mechanism for glomerular disease in the patients with SC and Sβ(+) phenotypes. However, both phenotypes are associated with a high prevalence of albuminuria in childhood. Therefore, screening for albuminuria is advised in African children with sickle cell disease to detect early renal damage. FUNDING Paris Cité Sorbonne University (GrEX project) and Cardiology and Development.
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Affiliation(s)
- Brigitte Ranque
- Internal Medicine, Hôpital Européen Georges Pompidou, Assistance Publique des Hôpitaux de Paris, Paris, France; UMR S970, Université Paris Descartes, Inserm, Paris, France.
| | - Aymeric Menet
- Cardiology Unit, Groupement des Hôpitaux de l'Université Catholique de Lille, Lille, France
| | | | | | - Dapa Diallo
- Centre de Recherche et Lutte contre la Drépanocytose, Bamako, Mali
| | - Saliou Diop
- Centre National de Transfusion Sanguine, Dakar, Senegal
| | - Ibrahima Diagne
- Pediatrics Unit, Centre Hospitalier National d'Enfants Albert Royer, Dakar, Senegal
| | | | | | - David Chelo
- Cardiology Unit, Centre Mère et Enfant de la Fondation Chantal Biya, Yaoundé, Cameroon
| | - Guillaume Wamba
- Pediatrics Unit, Centre Hospitalier d'Essos, Yaoundé, Cameroon
| | - Mamadou Diarra
- Cardiology Unit, Centre Gynéco-obstétrique, Bamako, Mali
| | | | | | | | - Youssouf Traore
- Centre de Recherche et Lutte contre la Drépanocytose, Bamako, Mali
| | - Gaëlle Legueun
- Cardiology Unit, Centre Hospitalo-Universtaire de Fann, Dakar, Senegal
| | - Indou Deme-Ly
- Pediatrics Unit, Centre Hospitalier National d'Enfants Albert Royer, Dakar, Senegal
| | | | - Kouakou Boidy
- Hematology Unit, CHU de Yopougon, Abidjan, Côte d'Ivoire
| | - Ismael Kamara
- Hematology Unit, CHU de Yopougon, Abidjan, Côte d'Ivoire
| | | | - Xavier Jouven
- Cardiology Department, Hôpital Européen Georges Pompidou, Assistance Publique des Hôpitaux de Paris, Paris, France; UMR S970, Université Paris Descartes, Inserm, Paris, France
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Ranque B, Thiam M, Diallo D, Diop S, Diagne I, Sanogo I, Boidy K, Jouven X. Étude de la glomérulopathie drépanocytaire dans cinq pays d’Afrique subsaharienne : premiers résultats de l’étude CADRE. Rev Med Interne 2013. [DOI: 10.1016/j.revmed.2013.10.102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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