Relationship between Folate Status and Complete Blood Count (CBC) Parameters in Sickle Cell Anaemia (SCA) at Steady State in Aminu Kano Teaching Hospital, Kano, Nigeria

Aim: To determine the relationship between folate status and CBC parameters in SCA patients at steady state.

Study Design: Comparative cross-sectional study.

Setting: Departments of Haematology and Blood Transfusion and Paediatrics, Aminu Kano Teaching Hospital, Kano, Nigeria between April and August, 2017.

Methodology: One hundred and ten (110) each of SCA patients (subjects) in steady state and their age and sex matched controls were enrolled. Haemogram and folate levels were determined. Data were analysed with SPSS version 21.0 and p≤0.05 was considered significant.

Results: The mean age of the participants was 15.2±7.4 years with a range of 4 – 32 years. There was no significant difference between the SCA patients and controls on basis of age, sex and level of education (p >0.05). The prevalence of folate deficiency among SCA patients was 46.4% (serum) and 49.1% [red blood cell (RBC)] compared to controls 22.0% (serum) and 22.9% (RBC), p<0.05. SCA patients were more likely to develop folate deficiency than controls [OR (95% CI) for serum 3.1(1.7 to 5.5) and RBC 3.2(1.8 to 5.8)], p<0.05. Red cell folate deficiency is associated with low haematocrit and high red cell distribution width while serum folate deficiency was associated with low haematocrit, p<0.05.

Conclusion: Despite routine prescription of folic acid, SCA patients had a higher prevalence of folate deficiency and this was associated with lower haematocrit. We therefore recommend that, physicians should device criteria for assessing compliance with routine prescription and do folate assay for patients with persistent high RDW and low haematocrit in steady state.