TITLE:
Factors Associated with Haemolytic Anaemia in the Internal Medicine Department of the Douala General Hospital in Cameroon
AUTHORS:
Eveline Ngouadjeu Dongho, Brice Utrich Afana, Clémence Olemba, Jean Pierre Nda Mefo’o, Cécile Ebongue Okalla, Abdou Temfomo, Jules Clement Nguedia Assob, Henry Namme Luma
KEYWORDS:
Haemolytic Anaemia, Internal Medicine, DGH
JOURNAL NAME:
Open Journal of Blood Diseases,
Vol.13 No.2,
June
29,
2023
ABSTRACT: Introduction: Haemolytic anaemia (HA) is defined as a decrease in haemoglobin (Hb)
levels below baseline due to excessive and premature destruction of red blood
cells (RBCs) in the periphery resulting in a shortened life span of less than
120 days. Haemolysis can be corpuscular or extra-corpuscular. The aim of our
study was to investigate the factors associated with it for optimal management of patients hospitalised in internal
medicine at the Douala General Hospital (DGH). Methodology: We conducted an analytical
cross-sectional study, including all patients admitted to the
internal medicine department of the DGH from 11 February to 20 May 2022, and
excluding patients with non-compliant samples. The search for haemolytic
anaemia was carried out by means of blood count, reticulocyte count, blood
smear, unconjugated bilirubin, lactate dehydrogenase and direct Coombs test.
Sociodemographic, clinical and biological parameters were collected and
analysed. Correlation was defined for a p value 0.05. Results: This study included 147 patients, 50.34% of whom were men, for a sex
ratio of 1.01. The mean age was 52 ± 17.9 years. The most represented age group
was 56 - 70 years (n = 49; 33%) with extremes from 15 to 90 years. We counted
29.3% cases of haemolytic anaemia (HA) and 13.9% cases of autoimmune haemolytic
anaemia (AIHA). Haemolytic anaemia (HA) was present in 54.14% of men for a sex
ratio of 1.38; the most represented age group was 40 - 55 years, 37.2%. HA was
associated with jaundice (OR: 3.74, CI: [1.70 - 8.22], p = 0.001), HIV - AIDS
(OR: 2.72, CI: [0.98 - 7.53], p = 0.05), thrombocytopaenia (OR: 3.53, CI: [1.58
- 7.89], p = 0.02). LDH was elevated (OR: 2.86, CI: [1.30 - 6.26], p = 0.00) as
well as elevated reticulocyte count (OR: 3.84, CI: [1.75 - 8.44],
p = 0.01). Unconjugated bilirubin was
elevated in all these patients. In multivariate analysis, factors
associated with HA were a history of HIV/AIDS, jaundice, thrombocytopaenia and
elevated reticulocyte count. Conclusion: Hemolytic anaemia is common in internal medicine and is significantly associated with thrombocytopenia, HIV/AIDS infection and
jaundice.