Infection and Impact of Prophylaxis in Sickle Cell Children: A Cross-Sectional Study of 327 Sickle Cell Children Admitted in Emergency Department of Albert Royer Children Hospital in Dakar, Senegal

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Background: Pneumococcus has been identified in several studies as the infectious agent most frequently found in children with sickle cell disease. However, some studies note an emergence of other infectious agents, especially in sub-Saharan Africa. Prophylactic measures, mainly targeting pneumococcus, our study aimed to describe the epidemiological, clinical and biological aspects of infections in children with sickle cell disease and to measure the impact of prophylactic anti-infectious measures. Methods: We conducted a cross-sectional study over a 5-month period from January 2022 to May 2022 in children and adolescents with sickle cell disease admitted to the emergency department of Albert Royer Children’s Hospital. Epidemiological, clinical, biological and therapeutic data were collected by Excel and used by SPSS 28.0 software. Results: of the 327 patients seen in the emergency room, 107 (32.7%) were admitted for infection. Pulmonary infection was the most common, with 46 patients (42%), followed by bone infections. Of the 46 blood cultures performed during this period, only one came back positive for pneumococcus. All patients initially received probabilistic antibiotic therapy. Vaccination coverage against pneumococcus was 19.26% in these patients. 60% of children under 5 were on antibiotic prophylaxis. There was a statistically significant association between the absence of vaccination coverage and the occurrence of infection. Conclusion: Infections account for around a third of emergency room admissions for children with sickle cell disease, and are dominated by respiratory and osteoarticular infections. Despite this, coverage of prophylactic measures such as vaccination and antibiotic prophylaxis remains low, due to their cost.

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