TITLE:
Acute Thoracic Syndrome in Children: Epidemiological, Diagnostic and Evolutionary Aspects at the Albert Royer National Children’s Hospital in Dakar Senegal
AUTHORS:
Guillaye Diagne, Papa Souleye Sow, Khadim Bop, Maimouna Sow, Idrissa Demba Ba
KEYWORDS:
Acute Chest Syndrome, Sickle Cell Disease, Children, Senegal
JOURNAL NAME:
Open Journal of Pediatrics,
Vol.13 No.6,
October
10,
2023
ABSTRACT: Acute chest syndrome (ACS) is a serious pulmonary complication of sickle
cell disease. It is estimated to be responsible for a quarter of deaths in the
pediatric sickle cell population. In Senegal, there are not enough pediatric
studies in this area. The objective of our
study was to determine the epidemiological, diagnostic and evolutionary
characteristics of ATS at the Albert Royer National Children’s Hospital
(CHNEAR) in Dakar. This was a retrospective study in patients hospitalized at
CHNEAR for ATS from January 1, 2021 to March 31, 2022. We included patients
hospitalized and diagnosed with ATS. We had collected 102 patients, i.e. a hospital incidence of 2.96%. The
average age of the children was 9 years old; the sex ratio was 1.04. The main symptoms on admission were hypoxemia
(97.06%), chest pain (77.45%), dyspnea (77.45%) and fever (65.69%).
52.94% of patients had an associated vaso-occlusive crisis (VOC). The chest
x-ray was abnormal in 92 patients, a rate of 90.20% and showed images of
pneumonia (71%); bronchitis (17.65%) and pleurisy (0.98%). None of the children
benefited from a pulmonary ultrasound. The
treatment associated with analgesics (100%),
broad-spectrum antibiotics (100%), oxygen therapy (100%), hydration (95.09%),
transfusion (73.53%), non-ventilation invasive (6.86%), intubation (2.94%) and
beta 2 mimetics (12.75%). No patient benefited from incentive spirometry. Almost all of the patients 95.10% (n = 97) had a
favorable clinical evolution. However, five children (4.90%) had an
unfavorable outcome including one case of complication such as stroke (0.98%)
and four (4) cases of death. The average hospital stay was 8 days. ATS is
common in children with sickle cell disease in Senegal and its etiologies seem
to be dominated by infectious causes in our context.