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This review investigated the spectrum of splenic complications encountered in SCD among populations in Africa. We systematically searched several databases for all articles published through March 3, 2020. We included 55 studies from 14 African countries. This review reveals the difference in frequency of splenic complications in SCD in Africa when compared with their counterparts in the United State and Europe. While several studies (<jats:italic>n<\/jats:italic>\u00a0=\u00a045) described splenomegaly with a prevalence of 12% to 73% among children, and 4% to 50% among adults with HbSS, the reported prevalence for acute splenic sequestration crisis (<jats:italic>n<\/jats:italic>\u00a0=\u00a06 studies) and hypersplenism (<jats:italic>n<\/jats:italic>\u00a0=\u00a04 studies) was &lt;10% and &lt;5% respectively. A total of 30 surgical splenectomy was reported across eight studies. Only two (3.7%) studies provided data on spleen function. A conflicting pattern was observed amongst studies that evaluated the relationship between splenomegaly and the presence of bacterial and malaria infections. This review reveals the paucity of studies describing the role of SCD\u2010induced splenic dysfunction in morbidity and infection related mortality in Africa.<\/jats:p>","DOI":"10.1111\/bjh.17179","type":"journal-article","created":{"date-parts":[[2020,11,8]],"date-time":"2020-11-08T05:30:11Z","timestamp":1604813411000},"page":"26-42","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["The spectrum of splenic complications in patients with sickle cell disease in Africa: a systematic review"],"prefix":"10.1111","volume":"193","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6943-8535","authenticated-orcid":false,"given":"Adama I.","family":"Ladu","sequence":"first","affiliation":[{"name":"Department of International Public Health Capacity Research Unit Liverpool School of Tropical Medicine Liverpool UK"},{"name":"Department of Haematology Faculty of Basic Clinical Sciences University of Maiduguri Maiduguri Borno State Nigeria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abiola O.","family":"Aiyenigba","sequence":"additional","affiliation":[{"name":"Department of International Public Health Capacity Research Unit Liverpool School of Tropical Medicine Liverpool UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adekunle","family":"Adekile","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Kuwait University Kuwait City Kuwait"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0862-8199","authenticated-orcid":false,"given":"Imelda","family":"Bates","sequence":"additional","affiliation":[{"name":"Department of International Public Health Capacity Research Unit Liverpool School of Tropical Medicine Liverpool UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,11,7]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1179\/136485907X154638"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1001484"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amepre.2011.09.013"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijid.2009.03.010"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(09)61374-X"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2010-04-278747"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjh.12950"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1080\/02724936.1988.11748549"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(02)09680-0"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.5402\/2011\/864257"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjh.14592"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1096-8652(199609)53:1<1::AID-AJH1>3.0.CO;2-V"},{"key":"e_1_2_10_14_1","doi-asserted-by":"crossref","first-page":"271","DOI":"10.4103\/1117-1936.177080","article-title":"Haematological parameters in sickle cell anaemia patients with and without splenomegaly","volume":"12","author":"Durosinmi MA","year":"2005","journal-title":"Niger Postgraduate Med J"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arcped.2010.04.015"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1651-2227.1990.tb11536.x"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1096-8652(199806)58:2<100::AID-AJH2>3.0.CO;2-W"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.10049"},{"key":"e_1_2_10_19_1","first-page":"33","article-title":"Indications for splenectomy among children with sickle cell disease in Kuwait","volume":"34","author":"Adekile A","year":"2002","journal-title":"Kuwait Med J"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1186\/1475-2875-13-335"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1080\/10245330600938422"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11739-019-02115-2"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.10010"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.25911"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2009.06.006"},{"key":"e_1_2_10_26_1","unstructured":"MoolaS MunnZ TufanaruC AromatarisE SearsK SfetcuR et al.Chapter 7: Systematic reviews of etiology and risk. 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