Table 3.
Incidence of admission to hospital with clinical conditions by sickle cell disease status
|
Non-sickle cell disease (n=15 574) |
Sickle cell disease (n=128) |
Adjusted incidence rate ratio (95% CI)* | p value | |||
|---|---|---|---|---|---|---|
| Events | Incidence | Events | Incidence | |||
| Clinical syndrome | ||||||
| All cause hospital admission | 3037 | 43 | 109 | 210 | 4·8 (3·8–6·1) | <0·0001 |
| Neonatal conditions†‡ | 496 | 413 | 1 | 101 | 0·3 (0·03–1·9) | 0·18 |
| Malaria§ | 241 | 3 | 1 | 2 | 0·5 (0·1–3·8) | 0·53 |
| Severe pneumonia¶ | 1004 | 14 | 24 | 46 | 3·8 (2·5–5·8) | <0·0001 |
| Very severe pneumonia¶ | 518 | 7 | 12 | 23 | 3·4 (1·9–6·1) | <0·0001 |
| Meningitis or encephalitis‖ | 1062 | 15 | 15 | 28 | 2·1 (1·2–3·6) | 0·0055 |
| Severe malnutrition** | 260 | 4 | 6 | 12 | 3·6 (1·6–8·1) | 0·0020 |
| Gastroenteritis†† | 600 | 8 | 7 | 13 | 1·8 (0·9–4·0) | 0·095 |
| Jaundice‡‡ | 110 | 2 | 17 | 33 | 20·4 (11·5–36·2) | <0·0001 |
| Other | 577 | 8 | 50 | 96 | 12·0 (8·5–16·1) | <0·0001 |
| Laboratory features and outcome | ||||||
| Bacteraemia | 364 | 5 | 15 | 29 | 6·0 (3·5–10·4) | <0·0001 |
| Malaria blood film positive | 270 | 4 | 1 | 2 | 0·5 (0·1–3·5) | 0·47 |
| Severe anaemia | 83 | 1 | 25 | 48 | 39·1 (24·5–62·5) | <0·0001 |
| Transfused | 101 | 1 | 20 | 38 | 27·0 (16·3–44·8) | <0·0001 |
| Hospital deaths | 47 | 0·7 | 4 | 8 | 11·0 (3·9–30·9) | <0·0001 |
Some children contributed data to more than one row. Incidence denotes episodes per 1000 person-years of observation. Person-years of observation for non-sickle cell disease admissions were 69 959 and 519 for sickle cell disease admissions.
Incidence rate ratios are adjusted for the α-thalassaemia genotype and ethnic group.
Data for the neonatal period reflect incidence per 1000 person-months of observation; person-months of observation were 15 568 for non-sickle cell disease participants and 128 for sickle cell disease participants.
Admission to hospital within the first 28 days of life.
A fever in the presence of Plasmodium falciparum parasitaemia at any density in children <1 year old or at a density of >2500 parasites per μL in older children.
Defined as described previously.1
Clinical detection of neck stiffness, prostration, or coma (Blantyre Coma Score <5), or a bulging fontanel.
A mid-upper-arm circumference of ≤7·5 cm in children <6 months or of ≤11·5 cm in children ≥6 months.
Diarrhoea (three or more loose watery stools per day) with or without vomiting (three or more episodes per day).
Clinical recognition of jaundice by the admitting clinician.