Risk Factors of avascular Osteonecrosis of the Femoral Head in Children at the National Reference Center for Sickle Cell Disease in Brazzaville, Congo

Tue, 02 May 2023 00:00:00 +0000

Introduction: The avascular osteonecrosis of the femoral head (AOFH) is a common complication of sickle cell disease (SCD). It exposes to lameness and sometimes to a very debilitating handicap. It is a source of desocialization, particularly in developing countries where prosthetic surgery remains inaccessible to the majority. This survey aimed to identify the risk of occurence AOFH.

Materials and Methods: It was a case-control study carried between october 2017 and september 2021 at the National Reference Center for SCD « Antoinette Sassou Nguesso » in Brazzaville. It concerned 31 children with clinical and radiographic signs of AOFH. Clinical (age at diagnosis of SCD, frequency of vasoocclusive crises and hospitalization for vasoocclusive crises, number of blood transfusion) as well as hematological examination (blood count in the intercritical period) and hydroxyurea treatment were compared with those of 62 children with no clinical and radiographic signs of AOFH. The chi2 statistical test and the odds ratio were used for the comparison (P ˂ 0.05).

Results: The sex ratio was 1.38 versus 0.93 (p = 0.50). The mean age of diagnostic of SCD was 3.76 ± 2.56 years versus 3.94 ± 2.01 years (p = 0.81). Logistic regression showed that SCD children with AOFH had a significantly higher rate of annual frequency of VOC (4.16 ± 1.18 vs 2.91 ± 1.68; P = 0.015), annual frequency of hospitalization for VOC (3.74±1.65 vs 1.45 ± 1.28; P = 0.000) and number of blood transfusions (3.38 ± 2.69 vs 2.42 ± 2.32; P = 0.03).

Conclusion: Emphasis should be placed on the prevention and early management of acute complications of SCD. The role of hydroxyurea should be clarified by further work.

Serum Ferritin as an Indicator of Neonatal Anaemia

Asinobi Isaac Nwabueze — Mon, 15 May 2023 00:00:00 +0000

Introduction: Haemoglobin levels are usually used to diagnose neonatal anaemia. By the time haemoglobin levels drop, body iron is depleted. Serum ferritin is the standard measure for assessment of iron levels in neonates and detects iron deficiency earlier than haemoglobin levels.

Aims: To determine the prevalence of low haemoglobin and ferritin levels amongst term and preterm newborn babies. To determine the value of serum ferritin in the diagnosis of low iron stores amongst term and preterm newborns.

Methodology: This was a cross sectional descriptive study carried out at the Neonatal Intensive Care Unit of the University of Nigeria Teaching Hospital (UNTH), Enugu, Nigeria between June and December 2014. The study included 140 newborns of all birth weights delivered at the UNTH. These were categorized into preterm (gestational age <37 completed weeks) and term (gestational age ≥37 completed weeks. Babies with C-reactive protein levels > 10mg/dl, who were intra-uterine growth restricted, and whose mothers had conditions associated with low iron stores were excluded from the study. Anthropometric measurements were done for all subjects. Haemoglobin estimation and ferritin assay were carried out and the prevalence of neonatal anaemia was determined using each of these.

Results: The range of haemoglobin concentration in the study population was 12.22g/gl – 22.80g/dl. The mean serum haemoglobin concentrations were 15.69mg/dl ± 1.58 and 16.45 ± 1.92 in the preterm and term babies respectively (t = 2.557, P = .0116). The prevalence of low haemoglobin concentrations amongst both preterm and term babies was zero= .024). The range of serum ferritin level in the study population was 20.6µg/l - 296µg/l. The mean serum ferritin levels were 63.13µg/l ± 23.93 and 133.67µg/l ± 50.14 in the preterm and term babies respectively (t = 10.623, P < .001). The prevalence of low serum ferritin in the study population was 22.14%, but was higher in preterm than term babies 35.7% vs 8.6%: (OR – 5.926, 95% C.I OR = 2.248 – 15.619)(P<.001).

Conclusion: Serum ferritin assay is more useful than haemoglobin as an indicator of anaemia during the neonatal period.

International Blood Research & Reviews

Risk Factors of avascular Osteonecrosis of the Femoral Head in Children at the National Reference Center for Sickle Cell Disease in Brazzaville, Congo

Serum Ferritin as an Indicator of Neonatal Anaemia