Gall bladder disorders at sonography among children with sickle cell disease at Mulago Hospital, Uganda
Abstract
Background: Gall bladder disorders (GBDs) are common in sickle cell disease (SCD) due to chronic hemolysis. Cholelithiasis, cholecystitis, gall bladder sludge and choledocholithiasis are among the most frequent forms of GBD. Despite a high burden of SCD in Uganda, there is limited published data on the prevalence of GBDs at sonography and associated factors among children with SCD.
Objective: To determine the prevalence and factors associated with GBDs at sonography among children with SCD in Uganda.
Methods: A descriptive, cross-sectional study was conducted, with systematic simple random sampling methods at Mulago National Referral Hospital (MNRH), Kampala, Uganda between October 2021, and February 2022. Children with SCD aged 6 months to 18 years were evaluated sonographically for GBDs. A semi-structured questionnaire was used to collect data of interest for the study. Binary logistic regression model was constructed to determine predictors of GBDs. A p< 0.05 was considered statistically significant.
Results: A total of 249 participants were recruited. The overall prevalence of GBDs was
22.1% (n=55). Of these, 37 (52.1%) had cholelithiasis and 3 (4.2%) had choledocholithiasis. The prevalence of GBDs increase with age with participants aged 6 —13 years had 5.4-folds higher odds of having GBDs compared to those aged <6 years (adjusted odds ratio (aOR) = 5.4, 95%CI: 2.3 — 12.8, p<0.001). The mean liver length was longer among patients with GBDs (13.5 ±2.4 versus 11.7 ±1.9 for normal liver, p<0.01). Gall bladder finding with right upper quadrant probe tenderness was associated with over 3-fold higher odds of having a GBD (aOR = 3.3, 95% CI: 1.2 — 12.5, p=0.025) and thickened gall bladder wall was associated with an almost 10-fold higher odds of having a GBD (aOR = 9.6, 95% CI: 1.8 — 17.0, p=0.008). There was no significant association of sex, Liver size use of hydroxyurea and underweight participants with GBDs in this age group.
Conclusion: The prevalence of GBDs in SCD in this age group is higher compared to other published studies and there is significant association of GBDs with increasing age.