The prevalence of cardiac complications among children with sickle cell disease, attending paediatric sickle cell clinic at Queen Elizabeth Central Hospital, Blantyre, Malawi

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Date
2020-11-11
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Kamuzu University of Health Sciences
Abstract
Study design: This is a Cross- sectional study. Problem statement Cardiovascular diseases like pulmonary hypertension, cardiomyopathy and left and right ventricular systolic and diastolic dysfunction are important complications and cause for morbidity and mortality among patients with Sickle Cell Disease. Routine monitoring for detection of these complications is recommended for early detection and institution of measures to mitigate them. The magnitude of these complications and how they present at Queen Elizabeth Central Hospital, paediatric Sickle Cell Disease clinic is not known. Over 120 children are routinely followed up in this clinic and monitoring for cardiovascular complications in not routinely done. This study aims at establishing the prevalence of cardiovascular complications in our cohort and characterising their presentation. Objectives: Primary objective: To characterise describe the prevalence of cardiac complications among children aged 2 to 16 years, attending paediatric sickle cell clinic. at Queen Elizabeth Central hospital. Secondary Objectives: 1. To determine the prevalence of characterise the cardiac complications among children aged 2 to 16 years, attending paediatric sickle cell clinic at Queen Elizabeth central hospital. 2. To determine the risk factors associated with cardiac complications among children aged 2-16-year, attending paediatric sickle cell clinic. at Queen Elizabeth Central Hospital. 3. To evaluate the clinical features of cardiacovascular complications among children aged 2- 16-year-old children attending paediatric sickle cell clinic at Queen Elizabeth Central Hospital. Research questions to be answered 1. What is the prevalence of cardiovascular complications of children ages 2-16 years attending paediatric sickle cell clinic at Queen Elizabeth Central Hospital? 2. What are the risk factors associated with these complications among these children? Methodology The study will be conducted at Queen Elizabeth Central Hospital paediatric Sickle cell clinic. 117 children aged 2-16 years will be recruited after screening and obtaining informed consent and assent from the guardian and the children who are able to give assent respectively. Data on medical history of the child will be collected from the health passport book and interviews. A comprehensive physical examination of the child will also be performed. This will be followed by an echocardiographic examination of the heart using an ultrasound machine. Data will be collected on a tablet fitted with an Open Data Kit (ODK) platform. The outcome variable of interest will be whether a child attending the clinic has cardiac complications. Descriptive analysis to obtain the prevalence of the cardiovascular complications and their characterisation will be done. This will be followed by bivariate and multivariate logistic regression analysis to identify the risk factors associated with these complications at a P-value of <0.05. Expected findings The prevalence of cardiovascular complications among children attending paediatric Sickle Cell clinic at Queen Elizabeth Central Hospital and the risk factors associated with them. Results dissemination The study report of all results will be submitted to the funders of the study and the College of Medicine – University of Malawi. College of Medicine Research Ethics Committee (COMREC) will also receive a copy as well as the participating patients that wish to receive the results. The results will further be submitted to a peer-reviewed journal for publication.
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