Predictors of hypoxaemia during steady-state among children with Sickle Cell Anaemia in North-Western Nigeria.

UNLABELLED: Abstract

BACKGROUND: Haemoglobin desaturation, which presents as hypoxaemia, is a known phenomenon in the cycle of red blood cells sickling in sickle cell anaemia (SCA). Thus, early and accurate recognition of hypoxaemia is important in order to ameliorate its adverse effects on vital organs. This study was carried out to investigate clinical and laboratory features that predict hypoxaemia in children with SCA during steady-state.

METHODS: We prospectively measured percutaneous haemoglobin saturation of 208 children with SCA in room air during steady-state at a secondary health facility in the north-west of Nigeria. Demographic, clinical and laboratory features and anthropometry were recorded. Hypoxaemia was defined as haemoglobin saturation < 90%. Chi square test and logistic regression were used to assess the associations of selected factors with hypoxaemia.

RESULTS: Participants comprised 132 males and 76 females and their age ranged from 9 to 168 months. Prevalence of hypoxaemia was 17.3%. Though hypoxaemia was significantly associated with age, time of first symptom to presentation, body mass index (BMI), weight-for-height z-score < 2.0, tachycardia, chest retraction and palpable spleen, age (OR = 0.78; 95% CI = 0.62, 0.96), time of first symptom to presentation (OR = 1.28; 95% = 1.03, 1.59), BMI (OR = 0.87; 95% = 0.76, 0.92) and palpable spleen (OR = 2.87; 95% CI = 1.43, 16.65) remained independent predictors in the logistic regression model.

CONCLUSION: Careful consideration should be given to time of first symptom to presentation, body mass index and palpable spleen when evaluating children with sickle cell anaemia for hypoxaemia in resource limited settings.