Objectives
Sickle Cell Disease (SCD) is a genetic blood disorder affecting over 1 million people globally. The aim of this analysis is to explore the pain burden of patients with SCD in two countries: the United States (U.S.) and Ghana.
Methods
The Consortium for the Advancement of Sickle Cell Research (CASiRe) was created to better understand the clinical severity of patients with SCD worldwide. Data regarding gender, SCD genotype, prior medical diagnoses, and validated pain burden measures were analyzed from the CASiRe database. The Sickle Cell Pain Burden Interview (SCPBI) was used to assess pain burden, the impact of pain on physical, emotional, and social function.
Results
Most subjects identified as Black/African American (n = 298, 97.0%). Patient ages ranged from 6 to 73 years. 35.9% resided in the U.S., 64.1% resided in Ghana, 40.9% were men, and 58.7% were women. The mean SCPBI score for U.S. SCD patients was 6.53(±5.89) vs. 4.04(±5.10) for Ghanaian patients, p<.001. Pain burden was higher in U.S. men vs. Ghanaian men (6.74(±5.68) vs. 3.54(±4.46), p=0.003) and in U.S. women vs. Ghanaian women (6.37 ± 6.06 vs. 4.44(±5.54), p=0.032). Pain burden was higher in U.S. patients than Ghanaian patients for both the Hb SC/SBeta+ genotype (5.40(±5.29) vs. 2.82(±4.86), p=0.054) and Hb SS/SBeta0 genotype (6.79(±6.01) vs. 4.49(±5.13), p=0.003). Pain burden was significantly higher in SCD patients with comorbid conditions independent of geographic origin including stroke, cholecystectomy, gallstones, depression, and headache.
Discussion
U.S. patients with SCD have a higher pain burden than Ghanaian patients. Further studies should investigate underlying contributors to pain burden in these populations and further explore the etiology of geographic differences in pain.