Serum Ferritin of Yemeni Patients with Sickle cell Anemia and Its Association with Socio-demographic Factors and Hematological Profiles

Background Iron overload remains one of the most common issue in patients with sickle cell anemia (SCA), with elevated ferritin (SF) levels contributing to significant morbidity . In Yemen, particularly in Sana’a, the burden of SCA is high; however, there is limited data addressing the prevalence of iron overload and its association with hematological parameters. The present study therefore aimed to determine the prevalence of iron overload by assessing SF levels in SCA patients at the Yemen Society for Thalassemia and Genetic Blood Disorders (YSTH) in Sana'a, and to investigate potential relationships between SF, hematological parameters, and socio-demographic characteristics. Methods A prospective cross-sectional study was conducted between June and December 2024. The study included 80 participants aged 15 years and older with a confirmed diagnosis of SCA attending the YSTH clinic. The data were analyzed using SPSS version 26. Descriptive statistics were performed for participant demographics, clinical, and laboratory characteristics. Bivariate analysis was used to calculate the crude odds ratio at (95% CI) between the dependent variable and all predictor variables. Spearman correlation test was performed to find the correlation of hematological parameters with SF. Statistical significance was considered at p < 0.05. Results The study enrolled 80 SCA patients with a mean (±SD) age of 18.5 (±3.69) years; of whom 65% were males and 35% were females. About 85% of patients had elevated SF level (>300 ng/ml), with a median (Range) of 1645 (77-4500). Red cell indices could not provide valuable information regarding the risk of hyperferritinemia. However, a significant positive correlation was observed between SF levels and white blood cell count ( P =0.02). No significant associations were found between socio-demographic factors and high SF levels. Conclusion The prevalence of hyperferritinemia was high among SCA patients attending the YSTH in Sana'a, Yemen. These findings emphasize the importance of iron overload screening before the start of treatment plan either with iron chelation or iron supplement therapy. Such early identification is critical for potentially delaying or preventing iron-induced organ toxicity, particularly cardiac and hepatic complications. We suggest further studies that take into consideration the limitations of this study and a detailed study on the transfusion status and inflammatory markers such as CRP.