Evaluation of the Clinical and Haematological Response to Hydroxyurea Treatment in Patients with Sickle Cell Disease Attending the Haematology Clinic at Jitimai District Hospital
Chukwuma J. Okafor
*
Department of Pathology and Biochemistry, State University of Zanzibar, Tanzania.
Othman Said Abdalla
Department of Internal Medicine, State University of Zanzibar, Tanzania.
Rodolfo Isidro Bosch Bayard
Department of Internal Medicine, State University of Zanzibar, Tanzania.
Diane Millo Martin
Department of Physiology, State University of Zanzibar, Tanzania.
Kenechukwu M. Okafor
Department of Surgery, State University of Zanzibar, Tanzania.
Hadiya Mahadhi Haji
Haematology Clinic, Jitimai District Hospital, Zanzibar, Tanzania.
Saida Salim Saleh
Haematology Clinic, Jitimai District Hospital, Zanzibar, Tanzania.
Thuwein Nassor Said
Haematology Clinic, Jitimai District Hospital, Zanzibar, Tanzania.
Aniuska Palacios Noa
Central Collaboration Unit, Ministry of Public Health, Cuba.
Emmanuel Ifeanyi Obeagu
Department of Biomedical and Laboratory Science, Africa University, Mutare, Zimbabwe.
*Author to whom correspondence should be addressed.
Abstract
Background: Sickle Cell Disease (SCD) is the most common and serious inherited disorder worldwide and ranks among the top 50 leading causes of non-communicable disease-related deaths globally. Africa bears a disproportionately large burden of these deaths. Various interventions have been implemented to reduce SCD-related mortality, with the use of Hydroxyurea (HU) demonstrating significant positive outcomes in decreasing both morbidity and mortality.
Objectives: to evaluate the response of patients with Sickle Cell Disease (SCD) treated with Hydroxyurea (HU) attending the haematology clinic at Jitimai District Hospital.
Methodology: The study was a descriptive hospital-based cross-sectional study conducted at the Haematology clinic. It involved a sample size of about 180, comprising both males and females of different age groups (children and adults) attending the Haematology clinic.
Result: The study showed that there is a significant positive response of hydroxyurea treatment to sickle cell disease patients both clinically and haematologically. Notably, there was a marked reduction in the frequency of painful crises, with the mean number dropping from 3.83 ± 0.8 before treatment to 1.80 ± 0.9 following treatment p<0.001. Hospitalization rates also decreased dramatically, falling from 3.09 ± 0.5 to 1.20 ± 0.5 (p< 0.001). The mean number of blood transfusions per patient dropped from 2.49 ± 0.9 to 1.11 ± 0.3. Perhaps most notably, there was a considerable increase in haemoglobin (Hb) levels, rising from a mean of 5.49 ± 1.2 g/dL to 7.82 ± 1.0 g/dL (p<0.001), demonstrating an enhanced oxygen-carrying capacity and overall improvement in patient health status. All observed changes were statistically significant using the T student test with p-values less than 0.001, strongly supporting the efficacy of hydroxyurea in reducing disease burden and improving hematologic parameters.
Conclusions: The study demonstrates that hydroxyurea therapy offers significant clinical and haematological benefits to SCD patients at Jitimai District Hospital, resulting in reduced hospitalizations, crises, and blood transfusions, increased haemoglobin levels, and improved quality of life, all within a favourable safety profile and with excellent patient adherence. The low side effects of these findings strongly support continued and expanded use of hydroxyurea as part of standard SCD management in this setting.
Keywords: Hydroxyurea, sickle cell disease, adherence, side effect, Zanzibar