[The importance of sickle cell anemia in a pediatric environment in Gabon].

According studies run during four years (1992-1995) in the Pediatric Unit of Libreville Hospital, to determine importance and features of sickle-cell disease in children in Gabon, profit and mode of regular follow-up, data of hospitalisation and management of children with sickle-cell disease were found as follow: Sickle-cell disease is third rank of admission motivations (13% of total admissions), and first after 4 years. Mortality is 8.4% of total mortality. Main causes of hospitalisation were acute anemia, painful crisis, and bacterial infections. Half of children had no medical follow-up, third was regularly checked, the remaining very irregularly, 80% of died children had no medical follow-up. A survey with an ambulatory taking-care which concerned 210 kids regularly checked, shows theses outcomes: the social families background was either medium or disavow. More than half of children were detected before one year, mainly by complication. Third had splenomegaly, 70% hepatomegaly and 40% were icteric. Based on 103 children tested for HIV, only 2 were found positive, but 22% were positive for HBs Ag. Growth, puberty and school retardation is a supplementary social handicap. A comparative with other cohorts must headlight genetic and personal environing matters. Unit of management of sickle-cell disease, annexed to a Pediatric Unit, provided that official acknowledgement, seems to be the best solution, as regards cost/efficiency, in the local context.