Conference abstract

Clinique Sikila: building up an outpatient clinic for children with sickle-cell disease in rural Niger

Pan African Medical Journal - Conference Proceedings. 2018:9(20).13 Dec 2018.
doi: 10.11604/pamj-cp.2018.9.20.747

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Keywords: Sickle-cell disease, Sub-Saharan Africa, children, outpatient treatment
Poster

Clinique Sikila: building up an outpatient clinic for children with sickle-cell disease in rural Niger

Julia Rappenecker1,2,&, Abdoul Kader Harouna Souley1, Malam Oumarou Moussoubahou1, Ann Moumina3, Ante Liesbeth Wind1,4, Daniel Martinez Garcia Magaria4

1Médecins Sans Frontières, Operative Centre Geneva, Geneva, Switzerland, 2Migrant Health Research, University of Basel Children’s Hospital, Basel, Switzerland, 3Médecins Sans Frontières, Operational Centre Geneva, Switzerland, 4Médecins Sans Frontières, Operational Centre Geneva, Women and Child Health, Nutrition Unit, Medical Department, Geneva, Switzerland

&Corresponding author
Julia Rappenecker, Médecins Sans Frontières, Operative Centre Geneva, Coordination, Niamey, Migrant Health Research, University of Basel Children’s Hospital, Basel, Switzerland

Abstract

Introduction: sickle cell disease is an increasing global health problem in children and a neglected disease in Sub-Saharan Africa particularly in humanitarian settings. So far, Médecins Sans Frontières (MSF) has little experience with sickle cell outpatient clinics. We describe our experience of setting-up an outpatient clinic for sickle cell patients in Magaria, Niger. Our aim was to provide a sickle cell outpatients treatment at the paediatric unit of Magaria (PU), to establish a systematic collection of data regarding sickle-cell patients, to evaluate the need for a more profound care including diagnosis via electrophoresis and treatment with hydroxyurea.

Methods: in phase I, all children presenting at the admission desk with clinical signs of sickle-cell disease and positive Emmel test were enrolled. They received a personal booklet, information regarding the disease, monthly consultations with test of their haemoglobin level, malaria screening, treatment with folic acid and zinc and pneumococcal vaccine on the first visit. In phase II, a separate tent for the outpatient clinic was built with two staff members working full time. For patients, respecting their consultations, a personal file was created to document further details of their course of disease.

Results: phase I of the project was implemented from April 2017 to mid-June. By the end of April, 263 patients were enrolled. Phase II started on June 26th. By the end of July, 411 patients were enrolled, 89% coming from Niger, 11% from Nigeria. 61% of the outpatients were respecting their first monthly visits.

Conclusion: there is an urgent need for systematic diagnostics, treatment and prevention of the disease, which has been underestimated. More systematic data has to be collected to gain knowledge about the prevalence, course of disease and effectiveness of treatment and prevention.