Feature of Older Patients with Sickle Cell Disease in the Congo

Special Article - Anaemia

J Blood Disord. 2017; 4(2): 1048.

Feature of Older Patients with Sickle Cell Disease in the Congo

Ngolet LO*, Atipo Tsiba Galiba FO, Malanda F, Ockouango Guelongo Ova JD and Elira Dokekias A

Clinical Hematology Unit, Marien Ngouabi University, Republic of Congo

*Corresponding author: Ngolet LO, Clinical Hematology Unit, Marien Ngouabi University, Brazzaville, Republic of Congo. BP: 32, Republic of Congo

Received: August 01, 2017; Accepted: September 26, 2017; Published: October 03, 2017


Background: Despite the high mortality rate of patients with sickle cell disease during the childhood in Africa, their life expectancy is increasing. Consequently, the number of adults is growing. Hence, health providers need to be aware about their clinical and biological pattern.

Patients and Methods: We studied clinical and biological aspects of 47 patients with sickle cell disease and phenotype SS aged 40 years and over from 2011 to 2016.

Results: The mean age was 45 (range: 40- 59) years. The female population was older with a mean age of 47 (p=0.05). Among them 53.3% reported a miscarriage episode sickle cell related. Twenty three over 47 (48.9%) had a low monthly income. Older adults presented sever sickle cell related acute morbidity, with a number of 1.83 vaso occlusive crisis, 2 anemic crisis/ blood transfusions and 1.59 admission episodes per year blood transfusion procedure episodes. In our group 57.44% developed a chronic complication. The most frequent complications of older patients with sickle cell disease were a vascular necrosis of the femoral head (19.14%) and leg ulcer (8.51%). Elevated regurgitate jet velocity was noticed on 10 over 12 (83.33%) heart failure symptomatic patients. The mean hemoglobin rate was 7.3g/dL.

Conclusion: Sickle cell related acute morbidity is high in older patients. Chronic complications are more frequent in this group and elevated regurgitate jet velocity more common finding.

Keywords: Sickle cell; Congo; Older adults; Morbidity.


Sickle cell disease is the most common inherited blood disorder in the Sub-Saharan where 75% of the 300,000 births worldwide live [1]. Few aspects of the sickle cell in the adulthood are known in the region because the mortality in the childhood is high. However despite our low resources, a slight decline in the mortality rate of SCD patients in Africa has been noticed due to improved supportive care such as malaria prophylaxis, SCD awareness, earlier diagnosis and better management care [2]. Consequently, childhood survival has improved and adult population with sickle cell disease is growing with the spectrum of clinical aspects that are for some unknown [3]. Reports of the adults’ natural history are spares and clinical aspects are unknown in the continent [4,5]. One study of homozygous HbSS SCD patients over 30 years of age was performed In the Congo. Thus we undertook to study SCD patients over 40 years of age.

Patients and Methods

Data collection and assessment procedure

We recruited through outpatient clinic in the hematology department HbSS SCD adult patients 40 years over of age. This study was carried from 2011 to 2016. Data were obtained from adult individuals who were receiving their care from the hematology department or new patients that consulted for sickness. Patients with sickle cell β0 and SC genotypes were excluded in the study.

All patients provided informed consent in accordance with the Declaration of Helsinski. Research protocol was approved by the local institution ethic board (CERSSA). Each patient was interviewed and data were collected in the SCD medical history form. We obtained the following data:


  1. Age
  2. Gender
  3. Employment status
  4. Income

The income of the family was interpreted based on the official lowest salary fixed by the Congolese government (XAF 90,000/ USD 153.53). The income was low when it was lower than XAF 90,000/ USD 153,53, middle when it was between than XAF 90,000/ USD 153,53 and XAF 500,000/ USD 852.96 and high when it was above XAF 500,000/ USD 852.96.

  1. Number of children per family
  2. Number of miscarriage SCD related for female patients

Morbidity: The number of crisis, hospitalization admissions and blood transfusion procedures that occurred during the study period.

Citation: Ngolet LO, Atipo Tsiba Galiba FO, Malanda F, Ockouango Guelongo Ova JD and Elira Dokekias A. Feature of Older Patients with Sickle Cell Disease in the Congo. J Blood Disord. 2017; 4(2): 1048. ISSN 2379-8009