Background
Children with sickle cell anemia have an increased risk for bacterial infections. Studies done in other parts of Sub-Saharan Africa have established the prevalence and etiology of bacteremia among children with sickle cell anemia (SCA), but there are no such studies in Uganda. This study aimed to determine the etiological patterns and factors associated with bacteremia among febrile children with SCA attending Jinja Regional Referral Hospital (JRRH).
Methods
This study employed an observational and analytical cross-sectional design. Febrile children with SCA at JRRH were enrolled. Information regarding their sociodemographic, medical and laboratory characteristics was obtained by asking the care taker or reviewing the medical records. At times, measurements were taken for the information not available in the records. Blood culture was done to assess for bacteremia. Binary logistic regression was done to determine the factors associated with bacteremia using Statistical Package for Social Sciences (SPSS) version 26. Descriptive statistics reporting frequency and percentage were used to report the prevalence and etiology. A p value < 0.05 was considered for significance.
Results
This study enrolled 209 children, majority of whom were males 114(54.5%). Most of the patients were young children under five years of age 116(55.5%). Of the 209 children enrolled, 44 had bacterial growth in their blood, translating into a prevalence of 21.1%. Of the 44 patients that had bacteremia, the commonest isolate was Staphylococcus aureus 25(56.8%), followed by Escherichia coli 8(18.2%), Klebsiella pneumoniae 3(6.8%) and Haemophilus influenzae 3(6.8%). Cloxacillin had good sensitivity against Staphylococcus aureus. All organisms were completely resistant to Gentamicin, Ampicillin, Penicillin and Ofloxacin. In the multivariate analysis, low maternal education level was statistically significant (aOR = 1.098, CI = 1.007–1.197, P = 0.037).
Conclusion
The prevalence of bacteremia was high. The commonest isolate was Staphylococcus aureus. Blood culture should be considered for all febrile patients with SCA especially those whose parents have low education. Other antibiotics should be considered in the management of these children with the exception of ampicillin and gentamicin, which carry high resistance rates.