Beyond Childhood: Adult and Adolescent Sickle Cell Disease and Outcomes in Northern Ghana

Abstract

Background: Adults and adolescents face different barriers to healthcare utilization compared to children. Objective: To describe adult and adolescent sickle cell disease (SCD) and outcomes in northern Ghana. Methods: This was a retrospective cohort study of SCD patients aged 13 years and above, admitted between January 1, 2021 and December 31, 2022 at the Komfo Anokye Teaching Hospital. The data was summarized with descriptive statistics and a multivariate logistics regression analysis was fitted to identify factors independently associated with prolonged hospital stay of more than 4 days. Results: Of the 326 admissions, 68.9% regularly attended their sickle cell clinics. Approximately 3% of all admissions into the internal medicine ward were due to SCD. Commonest complications observed were painful vaso-occlusive crisis (VOC) (78.1%), infection (51.2%), and hyperhemolysis (24.0%). Presented as adjusted odds ratio (95% CI), the predictors of prolonged hospital stay were: presence of comorbidities, 2.71 [(1.28, 5.97), p = 0.011]; infection, 1.78 [(1.08, 2.94), p = 0.024]; acute chest syndrome, 2.42 [(1.22, 4.970), p = 0.013]; hyperhemolysis, 2.02 [(1.08, 3.80), p = 0.028]; sequestration crisis, 3.80 [(1.50, 11.0), p = 0.008]; and requirement for transfusion, 3.58 [(1.80, 7.36), p < 0.001]. Mortality rate was 2.5%. Conclusion: SCD and its related complications constitute a significant proportion of all admissions into the adult medical ward. Approximately one in every three Ghanaian adult and adolescent SCD patients does not regularly attend the SCD clinic. Trial Registration: The authors have confirmed clinical trial registration is not needed for this submission.