Trends in Pediatric Sickle Cell Disease-Related Mortality in the United States, 1983-2002
Received 2 April 2008; received in revised form 3 September 2008; accepted 29 September 2008. published online 25 November 2008.
Objective
To analyze trends in sickle cell disease (SCD)-related mortality among black children during 1983-2002.
Study design
Using the multiple-cause mortality files compiled by the Centers for Disease Control and Prevention's National Center for Health Statistics, we analyzed deaths among children classified as black who were age 14 years and younger and had SCD identified on their death certificates.
Results
Relative to the rate for 1983-1986, the SCD mortality rate for 1999-2002 decreased by 68% (95% confidence interval [CI] = 58% to 75%) at age 0 to 3 years, by 39% (95% CI = 16% to 56%) at age 4 to 9 years, and by 24% (95% CI = −9% to 47%) at age 10 to 14 years. For the most recent period studied, a significant (42%) reduction in mortality at age 0 to 3 years was seen between 1995-1998 and 1999-2002, with essentially no reduction in SCD mortality at older ages.
Conclusions
Recent decreases in SCD mortality in black children under age 4 years coincided with the introduction of the 7-valent pneumococcal conjugate vaccine in 2000, although temporal association is not evidence of causation. The lack of significant recent reduction in SCD mortality in older children indicates the need for new treatment approaches.
National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA
Reprint requests: Dr Emad Yanni, Centers for Disease Control and Prevention, 1600 Clifton Rd, MS E-05, Atlanta, GA 30333
The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention. The authors declare no potential conflicts of interest, real or perceived.
ABSTRACT