Changing trends in sickle cell mortality

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The diagnosis of sickle cell disease (SCD) carries a significant risk of childhood death. Using data from the National Center for Health Statistics, Yanni et al from the CDC provide us with some current information on changing trends in this death risk over the past two decades. There have been significant reductions in mortality risk in the youngest children with SCD (under 3 years). These reductions have coincided with the introduction of the 7-valent pneumococcal conjugate vaccine, although the data do not permit attributing cause and effect to this. Unfortunately, there have been little changes in overall mortality in older children with SCD. The authors comment on the differences between this observation and those of cystic fibrosis, where major investments in research and the funding of clinical centers has resulted in major changes in mortality. Clearly, we have a long way to go in improving the care of children with SCD. In the meantime, however, the importance of the simple expedient of pneumococcal vaccination seems established.