Full Blood Count Abnormalities in Patients with Sickle Cell Anaemia During Febrile Episodes at the Teaching Hospital, Usmanu Danfodiyo University, Sokoto

This study evaluates full blood count abnormalities in patients with sickle cell anaemia (HbSS) during febrile episodes compared to steady-state values at Usmanu Danfodiyo University Teaching Hospital (UDUTH), Sokoto State, North West Nigeria. Febrile illness is a common precipitant of haematological decompensation in sickle cell anaemia, and characterising the specific blood count changes during fever-associated presentations aids clinicians in risk stratification and management decisions. A prospective paired study enrolled 80 HbSS patients who presented with febrile illness (temperature above 38 degrees Celsius) and had documented steady-state full blood count values within the preceding three months. Blood counts were compared between febrile and steady states. Results showed significant declines in haemoglobin and packed cell volume during febrile episodes, with the mean haemoglobin falling from 7.4 g/dL to 6.1 g/dL. Total white blood cell count increased significantly, driven by neutrophilia. Reticulocyte count declined in 28 percent of febrile episodes, suggesting aplastic crisis superimposed on haemolytic decompensation. Platelet count declined in 34 percent of patients during fever. Malaria co-infection was confirmed in 41 percent of febrile episodes by rapid diagnostic test, and these cases showed the most severe haematological changes. The study recommends aggressive febrile episode management including malaria exclusion, haematological monitoring, and low threshold for transfusion based on absolute haemoglobin decline criteria at UDUTH. Keywords: sickle cell anaemia, febrile episode, full blood count, aplastic crisis, Sokoto.