Cytomorphological assessment of buccal mucosal epithelial cells in Sudanese children with sickle cell anaemia: a pilot case-control study

Abstract Sickle cell anaemia (SCA) is an autosomal recessive disorder characterized by the presence of homozygous haemoglobin S. To compare the cytomorphological features of buccal mucosal epithelial cells in children with sickle cell anaemia (SCA) receiving treatment with those of healthy controls, in a pilot case-control study. Buccal smears were collected from 80 Sudanese children: 40 children with homozygous SCA (HbSS) receiving treatment (cases) and 40 clinically healthy children matched for age and sex (controls). Smears were fixed immediately in 95% ethanol, stained with the Papanicolaou (Pap) technique and examined qualitatively by a cytopathologist blinded to group allocation. Each smear was screened in its entirety for predefined features: nuclear enlargement, hyperchromasia, nuclear membrane irregularity and cytoplasmic changes. Data were analysed descriptively using SPSS version 26.0. Of the 40 cases, 22 (55%) were female and 18 (45%) were male, with a mean age of 9.48 years (range 3–15 years). No cytomorphological abnormalities were identified in the buccal smears of either cases or controls. In this pilot study, no cytomorphological differences were observed between treated children with SCA and healthy controls. Because no pretreatment assessment or untreated SCA group was available, these findings cannot be attributed to treatment. Larger prospective studies are needed.