Prevalence and factors associated with pneumonia and hospitalization in children below 5 years with sickle cell disease at Mulago hospital.

Abstract

Introduction. A 33% Streptococcal pneumoniae carriage rate has been reported in children with SCD in Mulago hospital. Use of penicillin prophylaxis and pneumococcal vaccine showed 85% and 68% reduction of invasive pneumococcal disease (IPD) in children with SCD respectively; however-current studies in other countries have reported 89.1% increase of IPD. Since the inception of pneumococcal vaccine, there has been no prevalence studies for pneumonia in children with SCD in Uganda. High hospitalization rate has been reported among children with SCD in both Africa and outside the African continent. However in Mulago hospital, little is known about factors associated with hospitalization among children below 5 years with SCD. Objectives. The study sought to determine the prevalence and factors associated with pneumonia and hospitalization in children below 5 years, with SCD in Mulago Hospital. Justification. The findings of this research is a good source of information about pneumonia, hospitalization and associated factors in children with SCD to the Mulago hospital management, Ministry of Health and other bodies like Sickle Cell Association Uganda. Methods. This was a cross sectional survey, with a sample size of 389 carried out between June and December 2017 at sickle cell clinic Mulago hospital. Standard structured pre-tested questionnaires were used to collect data from caretakers of children below 5 years with SCD in Mulago hospital. Results. The prevalence of pneumonia in children with SCD was 7.2% (95%CI: 5-10). Pneumonia was found to have statistically significant high risk of hospitalization compared to other illness (vaso-occlusion, stroke, bacterial infection) (OR 3.96, 95% CI: 1.56-9.99) at the multivariable model. Conclusion: In conclusion, the study found a low prevalence of pneumonia among children with SCD receiving care at the sickle cell clinic compared to other studies carried out in the similar setting. Pneumonia was found to be associated with hospitalization among children below 5 years, with SCD receiving care and treatment at the sickle cell clinic in Mulago hospital, between Jun to Dec 2017 which is in agreement with findings from similar setting.