Haemoglobin F (Hb F) Levels and Haematological indices in Hydroxyurea Treated Compared to Conventionally Treated Sickle Cell Anemia (SCA) Pediatric Patients in Sudan

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.