Impact of Hydroxyurea Therapy on Clinical Outcomes inChildren with Sickle Cell Anemia: A 5-year Study at Benue StateUniversity Teaching Hospital, Makurdi

Abstract

Sickle cell anaemia (SCA) is a chronic, debilitating condition prevalent in Nigeria. Hydroxyurea therapy has been
shown to reduce the frequency and severity of disease complications. However, its uptake in Nigeria has been limited
due to concerns about safety, accessibility, and awareness. This study aimed to evaluate the clinical and laboratory
outcomes of children with SCA on hydroxyurea therapy at the Benue State University Teaching Hospital, Makurdi,
Nigeria. A total of 43 children diagnosed with SCA were followed after initiation of hydroxyurea therapy. Data on sociodemographic
characteristics, frequency of SCA-related events and laboratory parameters were collected and analyzed
using SPSS version 23. Paired t-tests were used to compare pre- and post-treatment outcomes, and adverse effects were
recorded. The majority (65.1%) of the children were diagnosed with SCA by age two, and 60.5% started hydroxyurea
within two years of diagnosis. Hydroxyurea therapy significantly reduced the frequency of vaso-occlusive crises (mean
reduction from 7.70 to 1.91, p = .000), hospital admissions (mean reduction from 2.60 to 0.84, p = .000), and blood
transfusions (mean reduction from 1.51 to 0.40, p = .005). Hospital stay duration also decreased significantly (p = .001).
Laboratory findings showed significant reductions in WBC count (p = .001) and increases in MCV, while hemoglobin
levels remained stable. Mild skin pigmentation and dizziness were observed as adverse effects. Low-dose hydroxyurea
therapy in children with SCA resulted in substantial clinical benefits, including reduced disease complications and
improved laboratory markers, with minimal adverse effects.