Haematological Parameters of Sickle Cell Disease Patients on Prophylactic Antimalarial Regimen within Port Harcourt, Nigeria

Abstract

Introduction: Sickle cell disease (SCD) is caused by mutation in the β-globin, which results in gene substitution of Valine for Glutamic acid. SCD is prevalent in Plasmodium falciparum endemic regions such as Nigeria. Thus, haematological parameter of SCD patients during malaria infection may be affected. Prophylaxis against malaria is therefore important in SCD patients, as antimalarial chemoprophylaxis has also been shown to be beneficial in SCD patients, reducing parasitaemia and anaemia, and the requirement for blood transfusion. Aim: This study evaluated the haematological parameters of sickle cell disease patients on prophylactic antimalarial regimen within Port Harcourt, Rivers State, Nigeria. Methods: This cross sectional study investigated 50 Sickle Cell Disease Patients attending different hospitals within Port Harcourt and 50 apparently healthy staffs and students of River State University who served as control. Three (3ml) of blood was collected aseptically from each participant and analyzed for complete blood count using Haematology auto-analyzer (Sysmex XN-550) Results: The result show that male (51%) are more exposed to SCD in Port Harcourt than female (49%). There was a statistical significance in the Haemoglobin of Male (8.81±3.61) as compared to that of the female (11.62±3.77) (p=0.0097) while other parameters showed no statistical significance. The result showed a lower mean value for RBC, PCV, HB, MCV, MCH and MCHC of SCD patients on antimalarial regimen when compared to the control subjects. Higher mean value for WBC, Lymphocytes, Monocytes, and Eosinophils where statistically significant when compared with the control subjects. The result gotten emphasised the need for proper management of P. falciparum malaria in SCD. Conclusion: This study discovered that sickle cell disease patients are more of the age range between 18-21 years (50%), this might be attributed to the fact that many of the SCD patients pass away before they get old due to the disorder. This study has also established that Sickle Cell Disease patients on prophylactic anti-malarial regimen have low haemoglobin, haematocrit, RBC, MCV, MCH, and MCHC, but increased WBC, lymphocytes, monocytes and eosinophils. Results from this study can help in the differential diagnosis of malaria infection in HbSS genotype based on haematological parameters in resource limited setting where sickle cell genotyping remains a challenge.