{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T09:02:23Z","timestamp":1774602143085,"version":"3.50.1"},"reference-count":28,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2006,1,10]],"date-time":"2006-01-10T00:00:00Z","timestamp":1136851200000},"content-version":"vor","delay-in-days":9,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Paediatric Perinatal Epid"],"published-print":{"date-parts":[[2006,1]]},"abstract":"<jats:title>Summary<\/jats:title><jats:p>Dactylitis or hand\u2013foot syndrome is related to intravascular sickling and classically occurs around 6\u2003months of life when haemoglobin S levels reach pathological significance. It has been hypothesised as a possible predictive factor of adverse outcome.<\/jats:p><jats:p>The objective of this study was to estimate the survival without severe events (acute chest syndrome, stroke or death) according to early occurrence of dactylitis in the sickle cell paediatric cohort of Guadeloupe. The study period was 1 January 1984 to 31 December 1999. Medical data were recorded from birth for children with sickle cell anaemia diagnosed before 6\u2003months of age. The Kaplan\u2010Meier method was used to estimate the severe event\u2010free survival and to draw related curves. We used proportional\u2010hazard modelling to assess the risk of severe events (stroke or acute chest syndrome or death) in children with early dactylitis (before 6\u2003months of age).<\/jats:p><jats:p>The study sample comprised 114 children. The incidence [95% confidence interval] of clinical events per 100 child\u2010years were 10.0 [7.63, 13.07] for dactylitis, 0.73 [0.33, 1.62] for stroke, 10.88 [8.35, 14.17] for acute chest syndrome and 1.06 [0.56, 2.05] for death. Thirteen of the 14 children who had dactylitis before 6\u2003months of age had at least one severe event later in life. The median severe event\u2010free survival time was 2.1 [1.6, 2.7] years in children with dactylitis before 6\u2003months compared with 6.3 [4.5, 8.1] years in the other children;<jats:italic>P<\/jats:italic>\u2003&lt;\u20030.0005. After adjustment for haemoglobin level \u22647\u2003g\/dL (25th percentile), leucocyte count &gt;19\u2003000\/mm<jats:sup>3<\/jats:sup>(75th percentile), transfusion before age of one year, acute splenic sequestration before the age of one year, the adjusted hazard ratio of severe event for children with early dactylitis was 2.13 [1.06, 4.40];<jats:italic>P<\/jats:italic>\u2003&lt;\u20030.03. Dactylitis occurring before 6\u2003months of life identifies children at risk of severe complications who should benefit from close management.<\/jats:p>","DOI":"10.1111\/j.1365-3016.2006.00692.x","type":"journal-article","created":{"date-parts":[[2006,1,10]],"date-time":"2006-01-10T10:51:28Z","timestamp":1136890288000},"page":"59-66","source":"Crossref","is-referenced-by-count":13,"title":["Early onset dactylitis associated with the occurrence of severe events in children with sickle cell anaemia. The Paediatric Cohort of Guadeloupe (1984\u201399)"],"prefix":"10.1111","volume":"20","author":[{"given":"Lydia","family":"Foucan","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Didier","family":"Ekouevi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maryse","family":"Etienne\u2010Julan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"L Rachid","family":"Salmi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jean\u2010Pierre","family":"Diara","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2006,1,10]]},"reference":[{"key":"e_1_2_6_2_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199406093302303"},{"key":"e_1_2_6_3_2","doi-asserted-by":"publisher","DOI":"10.1182\/blood.V89.5.1787"},{"key":"e_1_2_6_4_2","doi-asserted-by":"publisher","DOI":"10.1182\/blood.V84.2.643.643"},{"key":"e_1_2_6_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0895-4356(96)00320-4"},{"key":"e_1_2_6_6_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.311.7020.1600"},{"key":"e_1_2_6_7_2","doi-asserted-by":"publisher","DOI":"10.1097\/00062752-199502020-00001"},{"key":"e_1_2_6_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(00)04132-5"},{"key":"e_1_2_6_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0248-8663(00)87225-2"},{"key":"e_1_2_6_10_2","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.20078"},{"key":"e_1_2_6_11_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF01956144"},{"key":"e_1_2_6_12_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM200001133420203"},{"key":"e_1_2_6_13_2","doi-asserted-by":"publisher","DOI":"10.1007\/978-1-4899-3115-3"},{"key":"e_1_2_6_14_2","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1111\/j.2517-6161.1972.tb00899.x","article-title":"Regression models and life tables","volume":"34","author":"Cox DR","year":"1972","journal-title":"Journal of the Royal Statistical Society"},{"key":"e_1_2_6_15_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199107043250103"},{"key":"e_1_2_6_16_2","doi-asserted-by":"publisher","DOI":"10.1182\/blood.V86.2.776.bloodjournal862776"},{"key":"e_1_2_6_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9343(78)90772-6"},{"key":"e_1_2_6_18_2","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2003-11-3758"},{"key":"e_1_2_6_19_2","first-page":"288","article-title":"Cerebrovascular accidents in sickle cell disease: rates and risk factors","volume":"91","author":"Ohene\u2010Frempong K","year":"1998","journal-title":"Blood"},{"key":"e_1_2_6_20_2","doi-asserted-by":"publisher","DOI":"10.1067\/mpd.2001.117580"},{"key":"e_1_2_6_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3476(05)80897-2"},{"key":"e_1_2_6_22_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM200006223422502"},{"key":"e_1_2_6_23_2","doi-asserted-by":"publisher","DOI":"10.1542\/peds.84.3.500"},{"key":"e_1_2_6_24_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3476(85)80230-4"},{"key":"e_1_2_6_25_2","doi-asserted-by":"publisher","DOI":"10.1016\/0929-693X(96)85059-7"},{"key":"e_1_2_6_26_2","first-page":"250","volume-title":"Sickle Cell Disease","author":"Serjeant G","year":"2001"},{"key":"e_1_2_6_27_2","doi-asserted-by":"publisher","DOI":"10.1542\/peds.103.3.640"},{"key":"e_1_2_6_28_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0197-2456(95)00098-4"},{"key":"e_1_2_6_29_2","doi-asserted-by":"publisher","DOI":"10.1097\/00043426-200007000-00009"}],"container-title":["Paediatric and Perinatal Epidemiology"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fj.1365-3016.2006.00692.x","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/j.1365-3016.2006.00692.x","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,1,7]],"date-time":"2025-01-07T01:07:03Z","timestamp":1736212023000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/j.1365-3016.2006.00692.x"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2006,1]]},"references-count":28,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2006,1]]}},"alternative-id":["10.1111\/j.1365-3016.2006.00692.x"],"URL":"https:\/\/doi.org\/10.1111\/j.1365-3016.2006.00692.x","archive":["Portico"],"relation":{},"ISSN":["0269-5022","1365-3016"],"issn-type":[{"value":"0269-5022","type":"print"},{"value":"1365-3016","type":"electronic"}],"subject":[],"published":{"date-parts":[[2006,1]]}}}