Environmental Factors as Determinants of Severity of SCD in Nigeria

Sickle cell anaemia (SCA) is a chronic blood disorder characterized by red blood cells that assume an abnormal sickle shape when deoxygenated and may block different areas of the microcirculation causing ischaemia in various organs. This study was carried out to find out the roles of environmental factors in determining the clinical severity of SCA in Nigeria. Subjects and Methods: This was a multicentre cross-sectional study amongst 261 SCA subjects in seven tertiary health care centres in Nigeria. After obtaining each Institution's ethics and research committee approval, a pretested structured questionnaire was administered to respondents by trained research assistants. Subjects were asked questions on number of crises, number of transfusions and number of hospitalizations in the previous one year Results: Jos Centre had the highest frequency (30%) of those who had more than three crises in the previous one year while Calabar (9.3%) and Lagos (10%) had the least. Frequency of more than three transfusions was highest in Maiduguri (6.3%) and Abuja(6.3%) respectively with Lagos, Enugu and Calabar centres in the southern part of Nigeria recording no transfusion during the study period. Calabar centre had the highest number of people (90.6%) who had not been transfused before and those who had not been hospitalized (71.9%). Maiduguri (16.7%) and Jos (15%) topped the number of those who had been hospitalized for more than three times while Lagos (0%) and Calabar (3.1) had the least. Conclusion: Altitude and hot weather are major environmental factors that contribute to the clinical severity of SCD in Nigeria.