Cargando…

Comparison between Adult Patients with Sickle Cell Disease of Sub-Saharan African Origin Born in Metropolitan France and in Sub-Saharan Africa

Sickle cell disease (SCD) prevalence has increased rapidly in Europe as a result of an increase in the life expectancy of these patients and the arrival of SCD migrants from Africa. The aim of our study was to compare the phenotypes of adult patients born in Sub-Saharan Africa (SSA) who migrated to...

Descripción completa

Detalles Bibliográficos
Autores principales: Honsel, Vasco, Khimoud, Djamal, Ranque, Brigitte, Offredo, Lucile, Joseph, Laure, Pouchot, Jacques, Arlet, Jean-Benoît
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6947353/
https://www.ncbi.nlm.nih.gov/pubmed/31835320
http://dx.doi.org/10.3390/jcm8122173
_version_ 1783485530827128832
author Honsel, Vasco
Khimoud, Djamal
Ranque, Brigitte
Offredo, Lucile
Joseph, Laure
Pouchot, Jacques
Arlet, Jean-Benoît
author_facet Honsel, Vasco
Khimoud, Djamal
Ranque, Brigitte
Offredo, Lucile
Joseph, Laure
Pouchot, Jacques
Arlet, Jean-Benoît
author_sort Honsel, Vasco
collection PubMed
description Sickle cell disease (SCD) prevalence has increased rapidly in Europe as a result of an increase in the life expectancy of these patients and the arrival of SCD migrants from Africa. The aim of our study was to compare the phenotypes of adult patients born in Sub-Saharan Africa (SSA) who migrated to France with those of patients with the same origin who were born in France. This single-center observational study compared the demographic, clinical and biological characteristics of SCD adult patients of SSA origin who were born in France or SSA. Data were collected from computerized medical charts. Groups were compared using multivariate logistic regression with adjustment for age, gender and type of SCD. Of the 323 SCD patients followed in our center, 235 were enrolled, including 111 patients born in France and 124 patients born in SSA. SCD genotypes were balanced between groups. Patients born in Africa were older (median age 32.1 (24.4–39) vs. 25.6 (22.1–30.5) years, p < 0.001) and more often women (n = 75 (60.5%) vs. 48 (43.2%), p = 0.008). The median age at arrival in France was 18 years (13–23). The median height was lower among patients born in SSA (169 (163–175) vs. 174.5 cm (168–179), p < 0.001). Over their lifetimes, patients born in France had more acute chest syndromes (median number 2 (1–4) vs. 1 (0–3), p = 0.002), with the first episode occurring earlier (19 (11.6–22.3) vs. 24 (18.4–29.5) years, p < 0.007), and were admitted to intensive care units more often (53.3% vs. 34.9%, p = 0.006). This difference was more pronounced in the SS/Sβ0 population. Conversely, patients born in SSA had more skin ulcers (19.4% vs. 6.3%, p = 0.03). No significant differences were found in social and occupational insertion or other complications between the two groups. Patients born in SSA had a less severe disease phenotype regardless of their age than those born in France. This difference could be related to a survival bias occurring in Africa during childhood and migration to Europe that selected the least severe phenotypes.
format Online
Article
Text
id pubmed-6947353
institution National Center for Biotechnology Information
language English
publishDate 2019
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-69473532020-01-13 Comparison between Adult Patients with Sickle Cell Disease of Sub-Saharan African Origin Born in Metropolitan France and in Sub-Saharan Africa Honsel, Vasco Khimoud, Djamal Ranque, Brigitte Offredo, Lucile Joseph, Laure Pouchot, Jacques Arlet, Jean-Benoît J Clin Med Article Sickle cell disease (SCD) prevalence has increased rapidly in Europe as a result of an increase in the life expectancy of these patients and the arrival of SCD migrants from Africa. The aim of our study was to compare the phenotypes of adult patients born in Sub-Saharan Africa (SSA) who migrated to France with those of patients with the same origin who were born in France. This single-center observational study compared the demographic, clinical and biological characteristics of SCD adult patients of SSA origin who were born in France or SSA. Data were collected from computerized medical charts. Groups were compared using multivariate logistic regression with adjustment for age, gender and type of SCD. Of the 323 SCD patients followed in our center, 235 were enrolled, including 111 patients born in France and 124 patients born in SSA. SCD genotypes were balanced between groups. Patients born in Africa were older (median age 32.1 (24.4–39) vs. 25.6 (22.1–30.5) years, p < 0.001) and more often women (n = 75 (60.5%) vs. 48 (43.2%), p = 0.008). The median age at arrival in France was 18 years (13–23). The median height was lower among patients born in SSA (169 (163–175) vs. 174.5 cm (168–179), p < 0.001). Over their lifetimes, patients born in France had more acute chest syndromes (median number 2 (1–4) vs. 1 (0–3), p = 0.002), with the first episode occurring earlier (19 (11.6–22.3) vs. 24 (18.4–29.5) years, p < 0.007), and were admitted to intensive care units more often (53.3% vs. 34.9%, p = 0.006). This difference was more pronounced in the SS/Sβ0 population. Conversely, patients born in SSA had more skin ulcers (19.4% vs. 6.3%, p = 0.03). No significant differences were found in social and occupational insertion or other complications between the two groups. Patients born in SSA had a less severe disease phenotype regardless of their age than those born in France. This difference could be related to a survival bias occurring in Africa during childhood and migration to Europe that selected the least severe phenotypes. MDPI 2019-12-09 /pmc/articles/PMC6947353/ /pubmed/31835320 http://dx.doi.org/10.3390/jcm8122173 Text en © 2019 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Honsel, Vasco
Khimoud, Djamal
Ranque, Brigitte
Offredo, Lucile
Joseph, Laure
Pouchot, Jacques
Arlet, Jean-Benoît
Comparison between Adult Patients with Sickle Cell Disease of Sub-Saharan African Origin Born in Metropolitan France and in Sub-Saharan Africa
title Comparison between Adult Patients with Sickle Cell Disease of Sub-Saharan African Origin Born in Metropolitan France and in Sub-Saharan Africa
title_full Comparison between Adult Patients with Sickle Cell Disease of Sub-Saharan African Origin Born in Metropolitan France and in Sub-Saharan Africa
title_fullStr Comparison between Adult Patients with Sickle Cell Disease of Sub-Saharan African Origin Born in Metropolitan France and in Sub-Saharan Africa
title_full_unstemmed Comparison between Adult Patients with Sickle Cell Disease of Sub-Saharan African Origin Born in Metropolitan France and in Sub-Saharan Africa
title_short Comparison between Adult Patients with Sickle Cell Disease of Sub-Saharan African Origin Born in Metropolitan France and in Sub-Saharan Africa
title_sort comparison between adult patients with sickle cell disease of sub-saharan african origin born in metropolitan france and in sub-saharan africa
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6947353/
https://www.ncbi.nlm.nih.gov/pubmed/31835320
http://dx.doi.org/10.3390/jcm8122173
work_keys_str_mv AT honselvasco comparisonbetweenadultpatientswithsicklecelldiseaseofsubsaharanafricanoriginborninmetropolitanfranceandinsubsaharanafrica
AT khimouddjamal comparisonbetweenadultpatientswithsicklecelldiseaseofsubsaharanafricanoriginborninmetropolitanfranceandinsubsaharanafrica
AT ranquebrigitte comparisonbetweenadultpatientswithsicklecelldiseaseofsubsaharanafricanoriginborninmetropolitanfranceandinsubsaharanafrica
AT offredolucile comparisonbetweenadultpatientswithsicklecelldiseaseofsubsaharanafricanoriginborninmetropolitanfranceandinsubsaharanafrica
AT josephlaure comparisonbetweenadultpatientswithsicklecelldiseaseofsubsaharanafricanoriginborninmetropolitanfranceandinsubsaharanafrica
AT pouchotjacques comparisonbetweenadultpatientswithsicklecelldiseaseofsubsaharanafricanoriginborninmetropolitanfranceandinsubsaharanafrica
AT arletjeanbenoit comparisonbetweenadultpatientswithsicklecelldiseaseofsubsaharanafricanoriginborninmetropolitanfranceandinsubsaharanafrica