Halliru K., 15

Fifteen-year-old Halliru Kabiru lives with sickle cell disease, one of three children battling the condition in his father's large household of two wives and 13 children. His father, a herbal medicine seller, is the sole provider, earning about 40,000 naira a month for the whole family. Home has no electricity, the children pay 150 naira at a vendor's shop to charge a phone, and water comes from a community borehole. Some children attend government schools, others Almajiri Islamic schools. Halliru was struck by sudden, throbbing pain in his left knee that worsened with every movement, alongside low-grade fever and body weakness. It is a vaso-occlusive crisis, where sickled blood cells block his vessels and starve the bone of oxygen. After three similar episodes in the past year managed as an outpatient, this crisis has now put him in hospital for his first admission.

Halliru, a known SCD patient, was admitted with 2 days history of severe left knee pain with low grade fever. X-ray ruled out fracture and osteomyelitis. PCV was 26%. He was managed for 8days on admission with IV fluids, IV Tramadol + IV Diclofenac for pain, oral Ibuprofen, Folic Acid, and warm compress to the affected knee. His pain improved significantly by day 3 and he became ambulatory with minimal discomfort. No features of infection or acute chest syndrome. PCV remained stable. He was stable for discharge on oral medications and physiotherapy advice.

With prompt treatment including IV fluids, analgesics, and monitoring, Halliru’s vaso-occlusive crisis is expected to resolve, the severe knee pain will reduce, and he can return to school with preserved joint function and no long-term damage. Proper hydration and pain management will also prevent worsening of the mild anemia and reduce the risk of further sickling episodes. If left untreated, the pain can worsen, leading to recurrent VOCs, possible joint damage, increased risk of infection, and progressive anemia that could affect his growth and quality of life.