Epidemiology of Leg Ulcers in Sickle Cell Disease Patients- A Multicenter Study
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Abstract
Background: Sickle cell leg ulcers contribute to significant morbidity in patients with sickle cell disease (SCD). Nigeria has the highest burden of SCD with a significant proportion of affected patients having chronic leg ulcers. This study aimed to determine the sociodemographic, clinical and haematological characteristics of SCD patients with leg ulcers in Benin City, Nigeria.
Methodology: This was a multicenter based cross-sectional study conducted at the University of Benin Teaching hospital (UBTH) and the sickle center, Benin City between June 2023 and November 2023 among SCD patients. Eighty-eight persons were recruited in this study, comprising of 33 SCD patients with leg ulcers, 33 SCD patients and 22 genotype AA individuals. Data were analysed using the Statistical Package for Social Sciences (SPSS) version 23.
Results: The mean age (SD) of SCD patients with leg ulcers, SCD controls and HbAA controls were 29±6.6yrs, 29.3±5.9yrs and 29.9±6.7yrs respectively. The differences in mean age across the study groups were not statistically significant (p=0.932). Nineteen (57.6%) individuals with sickle cell leg ulcers were females and 14 (42.4%) were males. There was no statistically significant difference in the sex distribution (p=0.521).
Conclusion: The prevalence of leg ulcers in SCD reduced with increasing age. Most leg ulcers occurred on the right leg at the medial malleolus and full blood count showed significantly elevated platelet count in patients with chronic leg ulcers compared to controls.
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References
1.Adewoyin AS. Management of sickle cell disease: a review for physician education in Nigeria (sub-Saharan Africa). Anemia. 2015; 2015(1):791498.
2.Vos T, Allen C, Arora M, Barber R. Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990–2015: a systematic analysis for the Global Burden of Disease Study 2015. The Lancet. 2016; 388 (10053): 1545-1602.
3.Serjeant GR. The natural history of sickle cell disease. Cold Spring Harb Perspect Med. 2013;3(10): a011783.
4.World Health Assembly, 59. (2006). Sickle-cell anaemia: report by the Secretariat. World Health Organization. Available from https://iris.who.int/handle/10665/20890
5.Nwogoh B, Adewoyin AS, Iheanacho OE, and Bazuaye GN. Prevalence of haemoglobin variants in Benin City, Nigeria. Annals of Biomed. Sci. 2012; 11(2): 60–64.
6.Minniti CP, Eckman J, Sebastiani P. Leg ulcers in sickle cell disease. AJH 2010; 85(10): 831-833.
7.Bazuaye GN, Nwannadi AI, Olayemi EE. Leg Ulcers in Adult sickle cell disease patients in Benin City, Nigeria. GJMS 2010; 8(2):190–194.
8.Umeh NI, Ajegba B, Buscetta AJ, Abdallah KE. The psychosocial impact of leg ulcers in patients with sickle cell disease: I don't want them to know my little secret. PLoS One. 2017; 12(10):e0186270.
9.Habibi A, Maryse E, Emmanuelle B, Maria D, Pagona F, Ersi V. Leg ulcers in sickle cell disease patients undergoing hydroxyurea therapy:insights from two large cohort studies. Blood. 2023;142(1):2500
10.Babalola OA, et al. Haematological indices of sickle cell patients with chronic leg ulcers on compression therapy. Afr J Lab Med. 2020; 9(1):1037.
11.Durosinmi MA, Gevao SM, Esan GI. Chronic leg ulcers in sickle cell disease: experience in Ibadan, Nigeria. Afr. J.Med.Sci. 1991; 20(1): 11-14.
12.Koshy M, Entsuah R, Koranda A. Leg Ulcers in Patients with Sickle Cell Disease. Blood.1989;74(4):1403-1408.
13.Akinyanju O, Akinsede I. Leg ulceration in sickle cell disease in Nigeria. Trop Geogr Med. 1979;31(1):87-91.
14.Idaewor PO, Enosolease MC, Momoh MI. Leg ulceration in a population of Nigerian patients with sickle cell anaemia – twenty years’ experience. Int Med Biomed Res.2002;1(1):18 -21.
15.Hassan A, Gayus DL, Abdulrasheed I, Umar MA, Ismail DL, Babadoko AA. Chronic leg ulcers in sickle cell disease patients in Zaria, Nigeria. Arch Int Surg. 2014; 4(3): 141–145.
16.Santos EDC, Santana PVB, Jesus LLS, Melo GIV, Yahouédéhou SCMA, Guarda CCD, Santiago RP. Leg Ulcers in Sickle Cell Disease: A Multifactorial Analysis Highlights the Hemolytic Profile. Hematol Rep. 2023;15(1):119-129.
17.M. Halabi-Tawil F, Lionnet R..Girot C, Bachmeyer PP, Levy S. Sickle cell leg ulcers: a frequently disabling commplication and a marker of severity. Br J Dermatol. 2008; 158(2): 339-344.
18.Hanmugam VK, Couch KS, McNish S, Amdur RL. Relationship between opioid treatment and rate of healing in chronic wounds. WRR. 2017;25(1):120–130.
19. Urhie OO, Awodu O, Okuonghae ME, Dirisu MI, Awotiku OO, Ibhayehor JO. Evaluation of Vonwilliebrand factor levels in sickle cell disease patient with leg ulcer in South-South Nigeria. World journal of pharmaceutical research 2026; 15(5): 803-816
20.Nwagha T.U, Nweke M & Ezigbo E.D. Contributions of von Willebrand factor to clinical severity of sickle cell disease: a systematic review and metanalysis. Hematology. 2022; 27(1):860-866.
21.Omer NE, Satti MH, Mohammed AO. Plasma level of von Willebrand factor: An indicator of severity in sickle cell disease. Sudan J.med.sci. 2009;4(2).
22.Monfort JB, Senet P. Leg Ulcers in Sickle-Cell Disease: Treatment Update. Adv Wound Care (New Rochelle).2020; 9(6):348-356.
23.Cumming V, King L, Fraser R, Serjeant G, Reid M. Venous incompetence, poverty and lactate dehydrogenase in Jamaica are important predictors of leg ulceration in sickle cell anaemia. Br J Haematol. 2008;142(1):119–125.
24.Madu AJ, Ubesie A, Madu KA, Okwor B, Anigbo C. Evaluation of clinical and laboratory correlates of sickle leg ulcers. WRR. 2013; 21(6) :808-812.