Increased risk of invasive bacterial infections in African people with sickle-cell disease: a systematic review and meta-analysis

Lancet Infect Dis. 2010 May;10(5):329-37. doi: 10.1016/S1473-3099(10)70055-4.


Children with sickle-cell disease are at great risk of serious infections and early mortality. Our Review investigates the association between sickle-cell disease and invasive bacterial disease among populations in Africa. We systematically searched published work extracted data on pneumonia, meningitis, and bacteraemia by sickle-cell disease status. Most studies identified lacked a control group and did not use best laboratory methods for culturing fastidious bacteria. Only seven case-control or case-cohort studies provided data on the association between invasive bacterial disease and sickle-cell disease status. For all-cause laboratory-confirmed invasive bacterial disease, the pooled odds of sickle-cell disease was 19-times greater among cases than controls. For disease caused by Streptococcus pneumoniae, the pooled odds of sickle-cell disease was 36-times greater; and for Haemophilus influenzae type b disease it was 13-times greater.

Publication types

  • Meta-Analysis
  • Research Support, Non-U.S. Gov't
  • Review
  • Systematic Review

MeSH terms

  • Africa
  • Anemia, Sickle Cell / complications*
  • Animals
  • Bacteremia / epidemiology
  • Bacterial Infections / epidemiology*
  • Child, Preschool
  • Humans
  • Infant
  • Meningitis, Bacterial / epidemiology
  • Pneumonia / epidemiology
  • Risk Factors