Current sickle cell disease management practices in Nigeria

Galadanci, Najibah A.; Wudil, Binta J.; Balogun, Taiwo Modupe; Ogunrinde, GO; Akinsulie, Adebola; Hasan-Hanga, F.; Mohammed, Abdullahi; Kehinde, MO; Olaniyi, John Ayodele; Diaku-Akinwumi, Ijeoma; Brown, Biobele J.; Adeleke, SI; Nnodu, Obiageli; Emodi, IJ; Ahmed, Sagir G.; Osegbue, A.O.; Akinola, N. O.; Opara, Hyginus; Adegoke, Samuel Ademola; Aneke, John C; Adekile, Adekunle

doi:10.1093/inthealth/iht022

Cited by 110 publications

(120 citation statements)

References 30 publications

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“…This was not unexpected as the study participants were unmarried youths compared to current study among married adults. A higher proportion of respondents in this study was aware and correctly identified their genotype in comparison to only 55 % awareness among respondents in a recent study in the same population (Galadanci et al 2014). However, the study was conducted among all mothers and not specifically mothers who have a child with sickle cell anemia.…”

Section: Discussioncontrasting

confidence: 80%

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Knowledge and awareness of personal sickle cell genotype among parents of children with sickle cell disease in southeast Nigeria

et al. 2015

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Sickle cell trait (SCT; HbAS), the heterozygous state for the sickle cell allele of the beta globin gene, is carried by as many as 100 million individuals worldwide. Nigeria has the highest prevalence of SCT, impacting an estimated 25 % of adult population. This study was designed to assess timing of awareness, knowledge of SCT status and preferred method of education among parents of children with sickle cell disease (SCD). We conducted a cross-sectional survey of parents of children with SCD from June 2013-March 2014. Participants completed a 20-item questionnaire to assess (1) awareness of personal sickle cell genotype, (2) timing of awareness of personal sickle cell genotype, and (3) knowledge of SCT. One hundred and fifty-five participants completed the survey. Seventy-eight percent were females, and 87 % (135/155) were aware of their own sickle cell genotype. Timing of awareness varied as follows: following birth of a child with sickle cell disease (45 %); during marriage (21.5 %); school admission (9.6 %); during pregnancy (9.6 %); and other times (14 %). Approximately 35.5 % of participants thought that sickle cell trait was a mild form of sickle cell disease. Radio (43.9 %), informational community meetings (27.7 %), and television (21.9 %) were identified by participants as the most effective method of increasing sickle cell trait awareness. Innovative approaches are needed to increase the proportion of individuals who are aware of their own sickle cell genotype prior to having a child with sickle cell anemia in line with the Healthy People 2020 objective.

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Section: Discussioncontrasting

confidence: 80%

“…In Nigeria, the prevalence SCT is estimated at 24 % (Taiwo et al 2011;WHO 2006). It is estimated that there are more than 40 million individuals who carry the sickle cell trait in Nigeria and more than 150,000 children born each year with SCA (Galadanci et al 2014).…”

Section: Introductionmentioning

confidence: 99%

Knowledge and awareness of personal sickle cell genotype among parents of children with sickle cell disease in southeast Nigeria

et al. 2015

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“…Estimates put SCD prevalence between 2 and 3%, in a population of 170 million Nigerians [2][3][4] . Low levels of awareness/ knowledge, poor case finding strategies and sub-optimal treatment continue to fuel morbidity and mortality rates in the country [5][6][7][8][9] . The introduction of novel agents such as hydroxyurea has greatly impacted on disease outcome in developed climes such as US [10][11][12][13] .…”

Section: Introductionmentioning

confidence: 99%

Hydroxyurea therapy in adult Nigerian sickle cell disease: a monocentric survey on pattern of use, clinical effects and patient’s compliance

2017

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Background: The clinical prospects of hydroxyurea therapy in the management of sickle cell disease (SCD) require evaluation in the Nigerian setting to develop indigenous guidelines. This survey examines the pattern of hydroxyurea therapy, its clinico-haematologic benefits and safety profile in Nigerian SCD subjects. Methods: A cross sectional pilot survey was carried out among 60 adult SCD subjects over 3 months. Data on clinical phenotypes, relevant haematological parameters and details of hydroxyurea therapy were obtained using a structured questionnaire through an interview process and case file review. Results: The median age was 30 years. Thirty-four (56.7%) of the subjects are aware of hydroxyurea therapy in SCD. Twenty-four (40%) SCD patients had previously used hydroxyurea. Only 4 subjects were fully compliant. Reasons for non-compliance included poor knowledge and lack of funds. In particular, hydroxyurea reduced leucocyte count and increased mean red cell volume (MCV) in compliant subjects. Conclusion: Hydroxyurea use is low among Nigerian SCD subjects despite its proven efficacy/clinical prospects in the developed nations. Large scale multicenter studies and clinical trials are needed to form a basis for developing standard local treatment protocol for its use.

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“…In this study, no patient had penicillin prophylaxis, a practice not in keeping with internationally accepted guidelines37. In a recent Nigerian study conducted across 18 sickle cell clinics, only eight of them routinely gave prophylactic penicillin38. This is in contrast to a study conducted in Brazil where 76.1% of the patient population received penicillin prophylaxis39.…”

Section: Discussionmentioning

confidence: 78%

Prescription audit in a paediatric sickle cell clinic in South-West Nigeria: A cross-sectional retrospective study

et al. 2018

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BackgroundSickle cell disease (SCD) is a genetic haematological disorder that affects millions of people around the world especially people of African heritage. The treatment of the symptoms of SCD includes the use of analgesics, antibiotics, and anti-malarial drugs. Studying the pattern of drug prescription is a veritable tool for establishing the current practice and how it conforms to existing guidelines.ObjectivesThe main objective of this study was to assess the pattern of drug prescription in children with sickle cell disease (SCD) attending the paediatric outpatients' clinic of a tertiary care centre in Ado-Ekiti, South-West Nigeria.MethodsThis was a cross-sectional retrospective study carried out using the medical records of all patients with SCD who attended the paediatric outpatient clinic of the teaching hospital between January 1 and December 31, 2014. The information retrieved from the case notes included the bio-demographic data, associated co-morbid conditions and the list of prescribed drugs.ResultsA total of 202 SCD patients aged below 18 years were seen in the clinic during the study period with males accounting for 61.9% of them. The mean age of all patients was 6.9 ±3.8 yrs. A total of 1015 medications were prescribed during the study period giving a mean of 5.02 ± 1.9. Vitamins/micronutrients, anti-malarial drugs, antibiotics and analgesics accounted for 41.4%, 29.0%, 15.7% and 13.9% of all prescribed drugs respectively. Antibiotics from the penicillin group were the most commonly prescribed followed by macrolides and cephalosporins while Ibuprofen (60.3%) and Acetaminophen (32.6%) were the commonly prescribed analgesics.ConclusionHigh rate of antibiotic prescription, low use of opioid analgesics and non-prescription of prophylactic penicillin/pneumococcal vaccination were the main findings in this study. There is need for the introduction of standard treatment protocols for this group of patients.

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Current sickle cell disease management practices in Nigeria

Abstract: The care available for SCD in Nigeria is still suboptimal and there is an urgent need for concerted effort to tackle the problem, but to make a significant impact on the burden of the disease would require more focus at the primary care level. Some steps to achieving this are outlined.

Cited by 110 publications

References 30 publications

Knowledge and awareness of personal sickle cell genotype among parents of children with sickle cell disease in southeast Nigeria

Knowledge and awareness of personal sickle cell genotype among parents of children with sickle cell disease in southeast Nigeria

Hydroxyurea therapy in adult Nigerian sickle cell disease: a monocentric survey on pattern of use, clinical effects and patient’s compliance

Prescription audit in a paediatric sickle cell clinic in South-West Nigeria: A cross-sectional retrospective study

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