Prevalence, Predictors, and Management of Acute Chest Syndrome in Patients with Sickle Cell Disease at Muhimbili National Hospital, Tanzania: A Retrospective Study.
8 affiliations
- 1Department of Haematology and Blood Transfusion, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.
- 2Sickle Pan-African Research Consortium (SPARCO) - Tanzania, Dar es Salaam, Tanzania.
- 3Department of Internal Medicine, Muhimbili National Hospital, Dar es Salaam, Tanzania.
- 4Department of Clinical Pharmacy and Pharmacology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.
- 5Department of Biochemistry and Molecular Biology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.
- 6Muhimbili Research Centre, National Institute for Medical Research, Dar es Salaam, Tanzania.
- 7National Blood Transfusion Service, Dar es Salaam, Tanzania.
- 8Department of Physiology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.
Abstract
Acute Chest Syndrome (ACS) is a potentially life-threatening complication of Sickle Cell Disease (SCD), contributing significantly to hospitalizations and mortality. While extensively studied in high-income settings, there is limited data on its prevalence, associated factors, and treatment patterns in Tanzania. To determine the prevalence, predictors, and management of ACS among SCD patients admitted at Muhimbili National Hospital (MNH), Dar es Salaam, between January 2019 and December 2024. A retrospective study was conducted using medical records of 1,257 SCD patients admitted to MNH. Data on demographics, clinical and laboratory characteristics, and treatment interventions were extracted and analyzed. Modified Poisson regression was used to identify factors associated with ACS. The prevalence of ACS was 24.3%. ACS was more likely among children under the age of five years compared to adults above 17 years (adjusted prevalence ratio [aPR] = 2.04, 95% CI: 1.76-2.38), in patients with upper respiratory tract infections (aPR = 1.62, 95% CI: 1.47-1.79) and in those with vaso-occlusive crises (aPR = 2.24, 95% CI: 2.12-2.38), while the use of hydroxyurea (aPR = 0.78, 95% CI: 0.78-0.79) and a history of asthma (aPR = 0.37, 95% CI: 0.27-0.47) were associated with a lower prevalence of ACS. Treatment offered included antibiotics (94.4%), pain management (87.2%), intravenous hydration (76.7%), oxygen therapy (43.9%), simple top-up blood transfusion (42.0%) and mechanical ventilation (9.8%). Exchange transfusion was underutilized (0.7%). ACS remains a common complication among patients with SCD admitted to MNH, particularly among younger patients and those presenting with upper respiratory tract infections or vaso-occlusive crises. Hydroxyurea use and a history of asthma were associated with a lower prevalence of ACS in this cohort. Exchange transfusion was the least utilized treatment modality despite current recommendations. These findings highlight the need to strengthen preventive strategies, improve access to hydroxyurea, and address barriers to advanced ACS management, including exchange transfusion.
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BibTeX
@article{masoud2026prevalence,
title = {{Prevalence, Predictors, and Management of Acute Chest Syndrome in Patients with Sickle Cell Disease at Muhimbili National Hospital, Tanzania: A Retrospective Study.}},
author = {Safia A Masoud and Mwashungi Ally and Helena Tom Kakumbula and Ahlam Nasser and Clara Chamba and Magdalena Lyimo and William Mawalla and Agnes Jonathan and Ritah Mutagonda and Florence Urio and Johnson Mshiu and Hilda Tutuba and Irene Kida Minja and Avelina Mgasa and Tunganege Edward Matipa and Julie Makani and Emmanuel Balandya},
journal = {Journal of blood medicine},
year = {2026},
month = oct,
doi = {10.2147/jbm.s603553},
url = {https://europepmc.org/article/MED/42953003},
note = {CC BY-NC},
}
RIS
TY - JOUR
TI - Prevalence, Predictors, and Management of Acute Chest Syndrome in Patients with Sickle Cell Disease at Muhimbili National Hospital, Tanzania: A Retrospective Study.
AU - Safia A Masoud
AU - Mwashungi Ally
AU - Helena Tom Kakumbula
AU - Ahlam Nasser
AU - Clara Chamba
AU - Magdalena Lyimo
AU - William Mawalla
AU - Agnes Jonathan
AU - Ritah Mutagonda
AU - Florence Urio
AU - Johnson Mshiu
AU - Hilda Tutuba
AU - Irene Kida Minja
AU - Avelina Mgasa
AU - Tunganege Edward Matipa
AU - Julie Makani
AU - Emmanuel Balandya
PY - 2026
DA - 2026/10/23
JO - Journal of blood medicine
DO - 10.2147/jbm.s603553
UR - https://europepmc.org/article/MED/42953003
AB - Acute Chest Syndrome (ACS) is a potentially life-threatening complication of Sickle Cell Disease (SCD), contributing significantly to hospitalizations and mortality. While extensively studied in high-income settings, there is limited data on its prevalence, associated factors, and treatment patterns in Tanzania. To determine the prevalence, predictors, and management of ACS among SCD patients admitted at Muhimbili National Hospital (MNH), Dar es Salaam, between January 2019 and December 2024. A retrospective study was conducted using medical records of 1,257 SCD patients admitted to MNH. Data on demographics, clinical and laboratory characteristics, and treatment interventions were extracted and analyzed. Modified Poisson regression was used to identify factors associated with ACS. The prevalence of ACS was 24.3%. ACS was more likely among children under the age of five years compared to adults above 17 years (adjusted prevalence ratio [aPR] = 2.04, 95% CI: 1.76-2.38), in patients with upper respiratory tract infections (aPR = 1.62, 95% CI: 1.47-1.79) and in those with vaso-occlusive crises (aPR = 2.24, 95% CI: 2.12-2.38), while the use of hydroxyurea (aPR = 0.78, 95% CI: 0.78-0.79) and a history of asthma (aPR = 0.37, 95% CI: 0.27-0.47) were associated with a lower prevalence of ACS. Treatment offered included antibiotics (94.4%), pain management (87.2%), intravenous hydration (76.7%), oxygen therapy (43.9%), simple top-up blood transfusion (42.0%) and mechanical ventilation (9.8%). Exchange transfusion was underutilized (0.7%). ACS remains a common complication among patients with SCD admitted to MNH, particularly among younger patients and those presenting with upper respiratory tract infections or vaso-occlusive crises. Hydroxyurea use and a history of asthma were associated with a lower prevalence of ACS in this cohort. Exchange transfusion was the least utilized treatment modality despite current recommendations. These findings highlight the need to strengthen preventive strategies, improve access to hydroxyurea, and address barriers to advanced ACS management, including exchange transfusion.
SN - 1179-2736
ER -