Incidence and Etiological Spectrum of Thrombocytopenia among Admitted Pediatric Patients in Major Hospitals, Sana'a City, Yemen 2022
DOI:
https://doi.org/10.65693/irss.2024.v5i1.326Keywords:
Thrombocytopenia, Pediatric patients, Etiological spectrumAbstract
AbstractBackground: Thrombocytopenia is characterized by decrease in platelet counts below 150,000 cells / micro L. It is a significant finding which is often missed in hospitalized patients if platelet parameters are not evaluated routinely. Therefore, this study aimed to determine the incidence and etiology of thrombocytopenia in pediatrics in major hospitals, Sana'a City, Yemen 2022.
Methodology: A retrospective cross-sectional descriptive study was conducted by collecting the data from the hospital's records of thrombocytopenic children aged (1-15 years), who admitted to the major public hospitals in Sana'a City, from January 1st, 2022 to December 31st, 2022. Data were collected and analyzed by using the (SPSS) version 26. Descriptive measures, including frequency, incidence, percentage, and standard deviation will be presented. Chi square was used to find association between age, gender and etiology and outcome. The test was considered to be significant when p value < 0.05. Approval from 21 September University was obtain.
Results: Two hundred and twenty-six thrombocytopenic paediatric patients were identified out of 3236 admitted patients recorded during the study period. The incidence for thrombocytopenia in paediatric patients was 7%. The majority of them were males (n = 130; 57.5%) and in the age group of < 5 years (n = 143; 63.3%). The majority of the thrombocytopenic patients accidentally identified by a primary care provider who performs a complete blood count (CBC) for other indications (n = 155; 68.6%), whereas the patients presented with bleeding symptoms were (n = 71; 26.7%), of whom (n = 64; 90.1%) were ecchymosis followed by epistaxis then hematuria. The most common nonspecific symptoms were fever (n = 199; 88%) followed by fatigability and pallor. The laboratory tests revealed that the majority of patients had severe thrombocytopenia (n = 66; 29.2%) followed by very severe thrombocytopenia (n = 59; 26%), that's platelets count equal 20,000-50,000/µl and <20,000/µl respectively. The findings revealed that the most common identified cause for all cases was Infectious diseases (especially post viral) (n = 95; 42%) followed by leukemia (n = 56; 24.8%) then anemia (n = 45; 20%).
Among the 226 cases of moderate and severe thrombocytopenia, 94 patients (42%) were required platelets transfusions. Only 17 patients required IV immunoglobulin therapy from a hematologist. The outcomes of the patients were cured (n = 77; 27.8%) followed by referred (n = 73; 26.4%) and died (n = 29; 10.5%). There are significance association between age factor and some etiologies including autoimmune, ITP, and post medication. The bleeding tendency was significantly associated with the severity of thrombocytopenia (p value < 0.05). There are relationship between the etiology of thrombocytopenia and the clinical characteristics, and outcomes (p value < 0.021).
Conclusion and Recommendations: In conclusion, thrombocytopenia is an important in admitted paediatric patients although the most common causes are infectious diseases and leukemia in the majority of cases. Several patients factors showed significant associations with etiology of thrombocytopenia. A complete CBC and platelet count were recommended before any medical intervention.
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