Presenting features at diagnosis and complications of hemophilia in Dakar: apropos of 25 cases

In order to describe the presenting features at diagnosis and complications of hemophilia in Dakar, we conducted a study of hospital records between October 1991 and January 1993. Twenty-five cases of hemophilia were identified. We found that only 4% of our patients were diagnosed in the first 6 months of life whereas 64% of patients were diagnosed between 6 months and 5 years of age, 32% were detected between 5 years and 14 years of age. The presenting feature at diagnosis was external bleeding in 60% of cases and internal bleeding in 40%. 92% of cases were hemophilia type A and only 8% hemophilia type B. 56% of patients had mild hemophilia, 40% moderate and only 4% severe disease. Hemophiliac arthropathy was present on radiography in 76%. Complications were dominated by repeated joint bleeding, which was present in 92% of patients, and repeated hematomas (80% of patients). A functional handicap was present in 60% of cases. 12% of transfused hemophiliacs developed an inhibitor and 4% of patients were HIV positive. Greater awareness of hemophilia amongst the medical community as well as continued efforts to improve care for hemophiliacs in Senegal are necessary.