Prevalence of Gallstones and Associated Factors Among Children and Adolescents with Sickle Cell Disease in Eastern Uganda

Augustine Owiny Okejomoe,1 Martin Chebet,1 Crispus Tegu,1 Julian Abeso,1 Kevin Achiro,2 Theoneste Hakizimana,3 Richard Katuramu,2 Ivaan Pitua,4 Christine Olwedo Adoch,5 Ezekiel Mupere,6 Peter Olupot-Olupot7 1Department of Pediatrics and Child Health, Busitema University, Mbale, Uganda; 2Department of Internal Medicine, Busitema University, Mbale, Uganda; 3Department of Obstetrics and Gynecology, Kampala International University, Ishaka, Bushenyi, Uganda; 4School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda; 5Department of Ear, Nose and Throat, Busitema University, Mbale, Uganda; 6Department of Pediatrics and Child Health, Makerere University, Kampala, Uganda; 7Directorate of Clinical Research, Mbale Clinical Research Institute, Mbale, UgandaCorrespondence: Augustine Owiny Okejomoe, Department of Pediatrics and Child Health, Busitema University, Mbale, Uganda, Email [email protected]: Sickle cell disease (SCD) predisposes patients to gallstone formation due to chronic hemolysis, which may result in complications such as cholecystitis and pancreatitis. Despite its clinical importance, there is limited data on the prevalence and risk factors of gallstones in children and adolescents with SCD in Uganda. This study aimed to determine the prevalence and associated factors of gallstones in children and adolescents with SCD in Eastern Uganda.Methods: A hospital-based cross-sectional study was conducted at Mbale Regional Referral Hospital from March to June 2024. We enrolled 208 children and adolescents aged 2– 19 years with confirmed SCD. Data on sociodemographic and clinical characteristics were collected using structured questionnaires. Abdominal ultrasound was performed to assess gallstone presence, and blood samples were analyzed for hematological and liver function parameters. Logistic regression was used to identify factors associated with gallstones.Results: The prevalence of gallstones was 31% (65/208). Adolescents aged 13– 19 years were more likely to have gallstones than younger children. Factors significantly associated with gallstones included jaundice adjusted prevalence ratio (aPr = 0.5, 95% CI: 0.4– 0.7, p < 0.001) and elevated gamma-glutamyl transferase (GGT) levels (aPr = 1.5, 90% CI: 0.9– 2.3, p = 0.051).Conclusion: The high prevalence of gallstones in children and adolescents with SCD emphasizes the need for routine screening. Routine ultrasound and liver function tests for children over 10 years may enable early detection and intervention, reducing complications.Keywords: gallstones, sickle cell disease, children, adolescents, Uganda, liver function