Prevalence of Anemia in Sickle Cell Patients in Ugandan Hospitals: A Narrative Review

Sickle cell disease (SCD), particularly sickle cell anemia (HbSS), is intrinsically a chronic hemolytic anemia, but the severity and hospital burden of anemia vary widely across patients and care settings. In Uganda, where SCD is common and malaria and undernutrition remain important co-morbid risks, anemia drives symptoms (fatigue, pallor), precipitates admissions, and increases transfusion demand. Using published Ugandan hospital/clinic evidence and global hemoglobin (Hb) diagnostic thresholds, this review summarizes: (i) how anemia is defined in SCD, (ii) facilitybased indicators of anemia severity in Ugandan SCD patients, and (iii) key drivers and clinical/public-health implications. Ugandan clinic data from Mulago show that ~25–28% of children in routine follow-up may have Hb <7 g/dL at assessment (notably excluding Hb <5 g/dL), while Northern Uganda hospitalization data report pallor in ~20% at presentation and transfusion in ~51% of admissions, suggesting frequent clinically significant anemia among inpatients. These findings underscore the need for standardized anemia severity reporting in SCD, routine evaluation for reversible contributors (malaria, parvovirus B19, iron deficiency where appropriate, helminths, renal disease), and context-appropriate transfusion and hydroxyurea strategies. Keywords: Sickle cell disease, sickle cell anemia, anemia prevalence, hemoglobin, transfusion, Uganda, Mulago Hospital, Gulu Regional Referral Hospital.