Lung function abnormalities and associated factors among children and adolescents aged 8-18years with Sickle cell anemia attending Sickle cell clinic at Muhimbili National Hospital.

Abstract

ABSTRACT Introduction: SCA is a chronic genetic disorder with multisystem complications that affects millions of children worldwide. One of the complications of SCA is lung function abnormalities. There have been conflicting findings on lung function among children with SCA, several demonstrating a restrictive pattern, although reports have shown that the obstructive form of the disease is the most prevalent. Despite the high prevalence of SCA globally, there is limited data on the magnitude of lung function abnormalities and associated factors among children and adolescents with SCA especially in SSA. Broad objective: To determine the proportion of lung function abnormalities and associated factors among children and adolescents aged 8-18 years with SCA attending sickle cell clinic at Muhimbili National Hospital. Methodology: This was a hospital-based cross-sectional study done at the SCA pediatric and adolescent outpatient clinic at MNH. An adapted structured questionnaire was used to collect data on the socio-demographic, environmental, and clinical characteristics of participants. Participants underwent physical examination and lung function assessment by spirometry. Abnormal lung function was defined as Forced Expiratory Volume in 1 second (FEV1) < 80% of the predicted value and < -1.64 of the Lower Limit of normal from the reference value. Data entry and analysis were done using Statistical Package for Social Sciences (SPSS) version 20. Continuous data were expressed as medians with respective interquartile ranges. The chi-square test was used to test for the association between categorical variables and the study outcomes. Univariable and multivariable logistic regression was used to assess for statistically significant associations with a set p-value of 0.05. Results:A total of 306 children and adolescents with SCA aged 8–18 years were recruited into the study; many of the participants were females 53.9%. The number of children and adolescents with abnormal lung function was 70 (22.9%), with most having an obstructive pattern 28 (9.5%).The majority of the participants, 226 (82.6%), were on hydroxyurea treatment, and 22.1% were underweight. There were no factors independently associated with abnormal lung function in the multivariate regression analysis. Conclusion: Abnormal lung function is commonamong children and adolescents attending sickle cell clinic at MNH. Noneof the studied factors was independently associated with abnormal lung function tests among children and adolescents with SCA. Recommendations:Regular spirometry screenings may be considered an integral component of comprehensive care for children and adolescents with sickle cell anemia (SCA). Additionally, future research should include additional variables like the duration and dosage of hydroxyurea, which may potentially influence abnormal lung function.