Abstract:
This is an observational analytical case control study conducted to compare haemoglobin F
levels in pediatric patients of sickle cell anaemia SCA, either treated with Hydroxyurea (HU) or
treated with conventional treatments. Three hundred twelve individuals were selected and informed
about the study objectives and their agreement for participation was obtained by using of a study
questionnaire, this was performed in the period between May-2009 to June-2010. Sixty one SCA
patients had been treated with HU were called group A1 and thirty sex SCA patients had been
treated with conventional managements but not with HU called group A2 those were visiting Jafar
Ibnouf Pediatric Hospital in Khartoum state, all were compared to 50 healthy individuals selected
randomly to be matched in age, sex and tribe as control called group B. The study also included
SCA patients at Heglig hospital in Heglig area (the petroleum filed) Western Sudan, seventy three
SCA patients had been treated with conventional managements were resident inside the petroleum
filed called group C1 and forty two SCA patients had been treated with conventional managements
from outside the petroleum filed called group C2, all are compared to twenty five healthy
individuals as control from inside the petroleum filed and twenty five from outside called group (D1
and D2) respectively. 2.5 ml of blood was collected from each individual into anticoagulated
container. Hb F levels determined by used of Denaturation method, complete blood count CBC
done by (Sysmex KX 21N) analyzer. Statistical package for social sciences (SPSS) program
version 13 was used for data processing. The mean ± Standard deviation (Mean ± SD) for the
patient’s age was (6.1±3.1), and the mod was 3.0 years. Fifty two % of patients were males and the
rest were females. The highest frequencies of patients were 121 found in Meseria tribe 57.1%. HbF
levels in group A1, C1 (8.0±2.6), (4.7±2.0) percent of the total Hb respectively, this were found to be
raised significantly when compared by group A2 (0.8±0.2) % and C2 (0.6±0.1) % with significant
probability value (p=0.000) in each groups. The CBC parameters and cell counts showed some
differences in groups A1 and C1 in compared with A2 and C2 respectively. Total white blood cells
(TWBCs) lower in group A1 and C1. Red blood cells (RBCs) and haemoglobin (Hb) increased
significantly in group A1 but no statistical changes in group C 1. Packed cell volume (PCV), mean
cell volume, (MCV) and mean cell haemoglobin (MCH) showed higher values in group A 1 and C1.
No significant change was seen in mean cell haemoglobin concentration (MCHC) in group A 1, but
was reduced in C1. Platelets and reticulocytes showed significantly reduced level in group A 1 and
C1. RBCs morphology showed no statistical changes in group A 1 and C1, When compared to A2 and
C2 of (p=0.325) and (p=0.878) respectively.
So, the study concluded that Hb F levels were raised significantly in SCA patient treated
with HU compared to the conventionally treated patients and the drug can be used
successfully in Sudan. Also as an important observation, patients resident inside the
petroleum filed showed significantly higher percentage of Hb F, though less than the HU
treated group, but opened an important new avenue for sickle cell anemia researches. In
addition patients inside the petroleum field showed similar behavior to the HU treated
group of significantly reduced Hospitalization and blood transfusion requirements, and
showed low frequencies of crises onset.