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ORIGINAL ARTICLE Table of Contents   
Year : 2017  |  Volume : 42  |  Issue : 3  |  Page : 167-169
The bone pain crisis of sickle cell disease and malaria: Observations from Gujarat, India

1 Chairman, Vision Medical Foundation for Rural Health and Research, Shishudeep Hospital, Bardoli, Gujarat, India
2 Secretary, Vision Medical Foundation for Rural Health and Research, Shishudeep Hospital, Bardoli, Gujarat, India
3 Sickle Cell Trust, Kingston, Jamaica, West Indies

Correspondence Address:
Graham R Serjeant
Sickle Cell Trust (Jamaica), 14 Milverton Crescent, Kingston 6, Jamaica
West Indies
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ijcm.IJCM_334_16

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Background: Sickle cell disease is a common problem across central India, but its clinical features may differ from that in African populations. There is a need to define the features of sickle cell disease in India, and the current study addresses some features of the bone pain crisis. Objectives: The objective of the study was to describe the epidemiology of the bone pain crisis of sickle cell disease in Gujarat and explore the relationship with infection by Plasmodium vivax. Materials and Methods: This was a prospective review of all admissions in patients with sickle cell disease to a private pediatric institution in Bardoli, Gujarat, in the year 2015. Hemoglobin electrophoresis of all patients was consistent with homozygous sickle cell disease, but family studies indicated that at least seven cases had the severe sickle cell-beta + thalassemia presumed to be the common IVS1-5G>C mutation. Clinical, hematological, and parasitological features were recorded. Results: There were 914 admissions among 654 patients who had between one and seven admissions. The bone pain crisis accounted for 763 (83%) of admissions and increased between July and October coinciding with the monsoon period. Blood smears were examined for malarial parasites in 811 admissions and were positive for P. vivax in 73% patients. There was no evidence that P. vivax infections varied with the cause of admission or increased during the monsoon period. Conclusions: There was a high prevalence of P. vivax infection in hospital admissions of sickle cell patients, but the data did not support an etiological role in the bone pain crisis. A trial of malarial prophylaxis might determine its effect on the clinical features and outcome of sickle cell disease.

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  2007 - Indian Journal of Community Medicine | Published by Wolters Kluwer - Medknow
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