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Abstract
RÉSUMÉ
Introduction. Malgré un fort ensoleillement, la carence en vitamine D reste un problème de santé publique en Afrique subsaharienne où prédomine la drépanocytose. L’objectif de l’étude était de rechercher une corrélation entre le taux sérique de la Vitamine D (25(OH)D) et les crises vaso-occlusives (CVO) chez les enfants drépanocytaires suivis au CME/FCB. Méthodes. Entre octobre 2019 et septembre 2020, une étude transversale analytique a été réalisé chez des enfants drépanocytaires SS de 3 à 18 ans au CME/FCB. Les données étaient collectées à l’aide d’un questionnaire et le dosage de la vitamine D était fait. Les données ont été analysées à l’aide du logiciel R version 3.6.1. La corrélation était établie à l’aide du coefficient de corrélation de Pearson avec vérification des conditions de validité du modèle d’ANOVA. Le seuil de significativité était à 5%. Résultats. Le taux de 25(OH)D était bas chez 83,7% des patients, soit 61,1% une carence et 22,6% une insuffisance. Sur les deux dernières années, 98% avaient eu les CVO allant de modérée à sévère ; 66% avaient été hospitalisés et 81% avaient été transfusés. Le nombre élevé de CVO était associé à un faible taux de 25(OH)D (Cor=-0,51, p<0.001***) ; l’intensité élevée des CVO étaient corrélés à un taux de 25(OH)D bas (Cor=-0,33 p=0,02673). Conclusion. La majorité des enfants drépanocytaires suivi au CME/FCB avait un taux sérique de 25(OH)D bas. Le nombre et l’intensité élevés des CVO étaient associés à un taux sanguin bas de 25(OH)D d’où la nécessité d’une supplémentation.
ABSTRACT
Background. Despite high sunshine levels, vitamin D deficiency remains a public health problem in sub-Saharan Africa where sickle cell disease predominates. The objective of the study was to investigate correlation between serum 25(OH)D levels and Vaso-occlusive crisis (VOCs) in sickle cell disease children followed at the CME/FCB. Methods: Between October 2019 and September 2020, an analytical cross-sectional study was conducted in 43 children with sickle cell disease SS aged 3-18 years at the CME/FCB. Data were collected using a questionnaire and vitamin D measurement was performed. Data were analyzed using R version 3.6.1 software. Correlation was established using Pearson's correlation coefficient with verification of the validity conditions of the ANOVA model. The significance threshold set at p < 0.05. Results: The 25(OH)D level was low in 83,7% of the patients, 61,1% deficiency and 22,6% insufficiency. Over the last two years, 98% had moderate to severe VOCs; 66% had been hospitalized and 81% had received transfusions. High number of VOCs was associated with low 25(OH)D (Cor=-0.51, p<0.001***); high intensity of VOCs was correlated with low 25(OH)D level (Cor=-0.33 p=0.02673). Conclusion. Most children with sickle cell disease followed up at the CME/FCB had low 25(OH)D serum levels. The high number and intensity of VOCs was associated with low 25(OH)D serum levels, hence the need for supplementation.
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References
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- Holick MF. The vitamin D deficiency pandemic: Approaches for diagnosis, treatment and prevention. Rev Endocr Metab Disord. 2017;18(2):153–65.
- Mogire RM, Mutua A, Kimita W, Kamau A, Bejon P, Pettifor JM, et al. Articles Prevalence of vitamin D deficiency in Africa : a systematic review and meta-analysis. Lancet Glob Heal. 2019;25(19):1–9.
- Ballas SK, Darbari DS. Review/overview of pain in sickle cell disease. Complement Ther Med. 2020;49:102327.
- Garrido C, Bardón-Cancho EJ, Fajardo-Sánchez V de los Á, Cascón-Pérez-Teijón ME, García-Morín M, Cela E, et al. Evaluation of the effectiveness of prophylactic oral vitamin D (cholecalciferol) in children with sickle cell disease. Bone. 2020;133:115228.
- Goodman BM, Artz N, Radford B, Chen IA. Prevalence of vitamin D deficiency in adults with sickle cell disease. J Natl Med Assoc. 2010;102(4):332–5.
- De Oliveira JF, Vicente NG, Santos JPP, Weffort VRS. Vitamin D in children and adolescents with sickle cell disease: an integrative review. Rev Paul Pediatr (English Ed). 2015;33(3):349–54.
- AlJama A, AlKhalifah M, Al-Dabbous IA, Alqudaihi G. Vitamin D deficiency in sickle cell disease patients in the Eastern Province of Saudi Arabia. Ann Saudi Med. 2018;38(2):130–6.
- Adegoke SA, Oyelami OA, Adekile A. Paediatrics and International Child Health Influence of serum 25-hydroxyvitamin D on the rate of pain episodes in Nigerian children with sickle cell anaemia. Paediatr Int Child Health. 2017;9047(March):1–5.
- Charan J, Biswas T. How to calculate sample size for different study designs in medical research?. Indian J Psychol Med. 2013;35(2):121-126.
- Osunkwo I, Hodgman EI, Cherry K, Dampier C, Eckman J, Ziegler TR, et al. Vitamin D deficiency and chronic pain in sickle cell disease. Br J Haematol. 2011;153(4):538–40.
- Awa M, Désiré H, Félicité D, Suzanne NU, Vanessa MF, Anasthasie AY, et al. Aspects Épidémiologiques , Cliniques et Thérapeutiques des Crises Vaso- Occlusives chez les Enfants Drépanocytaires en Milieu Hospitalier à Yaoundé Epidemiological , clinical and therapeutic aspects related to the occurrence of vaso - occlusive crises in . HEALTH SCIENCES AND DISEASE, [S.l.], v. 18, n. 4, oct. 2017.
- Margaret T Lee, MD, Maureen Licursi, CPNP, and Donald J McMahon M. Vitamin D Deficiency and Acute Vaso-occlusive Complications in Children With Sickle Cell Disease. Pediatr Blood Cancer. 2015;(62:643–647).
- Tara Christine Jacksona, Melissa Jo Krauss, MPHb, Michael Rutledge DeBaun, MD, MPHa,c,Robert Charles Strunk, MDa, and Ana Maria Arbeláez, MD M. Vitamin-D Deficiency and Comorbidities in Children with SickleCell Anemia. Pediatr Hematol Oncol. 2012 Apr; 29(3): 261–266.
- Han J, Zhang X, Saraf SL, Gowhari M, Molokie RE, Hassan J, et al. Risk factors for vitamin D deficiency in sickle cell disease. Br J Haematol. 2018;181(6):828–35.
References
Aude Tonson, Alexndre Wilhelm, Elsa gonzalez EG. Le point sur la vitamine D. paediatrica. 2012;23(409):18–9.
Holick MF. The vitamin D deficiency pandemic: Approaches for diagnosis, treatment and prevention. Rev Endocr Metab Disord. 2017;18(2):153–65.
Mogire RM, Mutua A, Kimita W, Kamau A, Bejon P, Pettifor JM, et al. Articles Prevalence of vitamin D deficiency in Africa : a systematic review and meta-analysis. Lancet Glob Heal. 2019;25(19):1–9.
Ballas SK, Darbari DS. Review/overview of pain in sickle cell disease. Complement Ther Med. 2020;49:102327.
Garrido C, Bardón-Cancho EJ, Fajardo-Sánchez V de los Á, Cascón-Pérez-Teijón ME, García-Morín M, Cela E, et al. Evaluation of the effectiveness of prophylactic oral vitamin D (cholecalciferol) in children with sickle cell disease. Bone. 2020;133:115228.
Goodman BM, Artz N, Radford B, Chen IA. Prevalence of vitamin D deficiency in adults with sickle cell disease. J Natl Med Assoc. 2010;102(4):332–5.
De Oliveira JF, Vicente NG, Santos JPP, Weffort VRS. Vitamin D in children and adolescents with sickle cell disease: an integrative review. Rev Paul Pediatr (English Ed). 2015;33(3):349–54.
AlJama A, AlKhalifah M, Al-Dabbous IA, Alqudaihi G. Vitamin D deficiency in sickle cell disease patients in the Eastern Province of Saudi Arabia. Ann Saudi Med. 2018;38(2):130–6.
Adegoke SA, Oyelami OA, Adekile A. Paediatrics and International Child Health Influence of serum 25-hydroxyvitamin D on the rate of pain episodes in Nigerian children with sickle cell anaemia. Paediatr Int Child Health. 2017;9047(March):1–5.
Charan J, Biswas T. How to calculate sample size for different study designs in medical research?. Indian J Psychol Med. 2013;35(2):121-126.
Osunkwo I, Hodgman EI, Cherry K, Dampier C, Eckman J, Ziegler TR, et al. Vitamin D deficiency and chronic pain in sickle cell disease. Br J Haematol. 2011;153(4):538–40.
Awa M, Désiré H, Félicité D, Suzanne NU, Vanessa MF, Anasthasie AY, et al. Aspects Épidémiologiques , Cliniques et Thérapeutiques des Crises Vaso- Occlusives chez les Enfants Drépanocytaires en Milieu Hospitalier à Yaoundé Epidemiological , clinical and therapeutic aspects related to the occurrence of vaso - occlusive crises in . HEALTH SCIENCES AND DISEASE, [S.l.], v. 18, n. 4, oct. 2017.
Margaret T Lee, MD, Maureen Licursi, CPNP, and Donald J McMahon M. Vitamin D Deficiency and Acute Vaso-occlusive Complications in Children With Sickle Cell Disease. Pediatr Blood Cancer. 2015;(62:643–647).
Tara Christine Jacksona, Melissa Jo Krauss, MPHb, Michael Rutledge DeBaun, MD, MPHa,c,Robert Charles Strunk, MDa, and Ana Maria Arbeláez, MD M. Vitamin-D Deficiency and Comorbidities in Children with SickleCell Anemia. Pediatr Hematol Oncol. 2012 Apr; 29(3): 261–266.
Han J, Zhang X, Saraf SL, Gowhari M, Molokie RE, Hassan J, et al. Risk factors for vitamin D deficiency in sickle cell disease. Br J Haematol. 2018;181(6):828–35.