Sickle Cell Disease in the Democratic Republic of Congo: Assessing Physicians’ Knowledge and Practices

Mbiya, Benoît Mukinayi; Disashi, Ghislain Tumba; Gulbis, Béatrice

doi:10.3390/tropicalmed5030127

Cited by 8 publications

(8 citation statements)

References 21 publications

(23 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…14 But due to inconsistent supply of medication in SSA, pain management is often restricted to level 2 analgesics. 15 Similarly, hydroxyurea is not routinely prescribed in Malawi and universal use policy is not available despite documented evidence of its safety and efficacy. 16 Previous studies have attributed under utilisation of hydroxyurea to provider inexperience, cost and inaccessibility.…”

Section: What This Study Adds?mentioning

confidence: 99%

Paediatric sickle cell disease at a tertiary hospital in Malawi: a retrospective cross-sectional study

Chimbatata

Chisale

Kayira

et al. 2021

bmjpo

View full text Add to dashboard Cite

IntroductionSickle cell disease (SCD) remains a major cause of childhood mortality and morbidity in Malawi. However, literature to comprehensively describe the disease in the paediatric population is lacking.MethodsA retrospective review of clinical files of children with SCD was conducted. Descriptive statistics were performed to summarise the data. χ2 or Fisher’s exact test was used to look for significant associations between predictor variables and outcome variables (case fatality and length of hospital stay). Predictor variables that were significantly associated with outcome variables (p≤0.05) in a χ2 or Fisher’s exact test were carried forward for analysis in a binary logistic regression. A multivariable binary logistic regression was used to identify covariates that independently predicted length of hospital stay.ResultsThere were 16 333 paediatric hospitalisations during the study period. Of these, 512 were patients with SCD representing 3.1% (95% CI: 2.9%- 3.4%). Sixty-eight of the 512 children (13.3%; 95% CI: 10.5% - 16.5%) were newly diagnosed cases. Of these, only 13.2% (95% CI: 6.2% - 23.6%) were diagnosed in infancy. Anaemia (94.1%), sepsis (79.5%) and painful crisis (54.3%) were the most recorded clinical features. The mean values of haematological parameters were as follows: haemoglobin (g/dL) 6.4 (SD=1.9), platelets (×109/L) 358.8 (SD=200.9) while median value for white cell count (×109/L) was 23.5 (IQR: 18.0–31.2). Case fatality was 1.4% (95% CI: 0.6% - 2.8%)and 15.2% (95% CI: 12.2% -18.6%) of the children had a prolonged hospital stay (>5 days). Patients with painful crisis were 1.7 (95% CI: 1.02 - 2.86) times more likely to have prolonged hospital stay than those without the complication.ConclusionAnaemia, sepsis and painful crisis were the most common clinical features paediatric patients with SCD presented with. Patients with painful crisis were more likely to have prolonged hospital stay. Delayed diagnosis of SCD is a problem that needs immediate attention in this setting. Although somewhat encouraging, the relatively low in-hospital mortality among SCD children may under-report the true mortality from the disease considering community deaths and deaths occurring before SCD diagnosis is made.

show abstract

Section: What This Study Adds?mentioning

confidence: 99%

Paediatric sickle cell disease at a tertiary hospital in Malawi: a retrospective cross-sectional study

Chimbatata

Chisale

Kayira

et al. 2021

bmjpo

View full text Add to dashboard Cite

show abstract

“… 28 Findings from this study indicated that comprehensive management of sickle cell disease, including specific interventions, such as neonatal screening, early diagnosis, preventive penicillin therapy, pneumococcal and haemophiliac influenza vaccination, and malaria prophylaxis, were all lacking. Mukinayi et al 29 highlighted poor diagnostic and treatment options as factors contributing to increased morbidity and mortality for sickle cell anaemia patients in the Democratic Republic of the Congo. Galadanci et al 14 reported similar findings in their study on current sickle cell disease management practices in Nigeria.…”

Section: Resultsmentioning

confidence: 99%

A Critical Review of Sickle Cell Disease Burden and Challenges in Sub-Saharan Africa

Adigwe¹,

Onoja²,

Onavbavba³

2023

JBM

View full text Add to dashboard Cite

Sickle cell disease is caused by an abnormality of the β-globin gene and is characterised by sickling of the red blood cells. Globally, sub-Saharan African countries share the highest burden of the disease. This study aimed at critically reviewing studies focusing on challenges of sickle cell anaemia in sub-Saharan Africa. A literature search was carried out in five major databases. Articles that met the inclusion criteria were included in the bibliometric review and critical analysis. A majority of the studies were undertaken in the West African region (85.5%), followed by Central Africa (9.1%). Very few studies had been undertaken in East Africa (3.6%), whilst the Southern African region had the fewest studies (1.8%). Distribution in relation to country revealed that three quarters of the studies were carried out in Nigeria (74.5%), followed by the Democratic Republic of the Congo (9.1%). According to healthcare settings, a strong majority of the studies were undertaken in tertiary health care facilities (92.7%). Major themes that emerged from the review include interventions, cost of treatment, and knowledge about sickle cell disease. Public health awareness and promotion as well as improving the quality of sickle cell centers for prompt management of patients with sickle cell disorder was identified as a critical strategy towards reducing the burden of the disease in sub-Saharan Africa. To achieve this, governments in countries located in this region need to adopt a proactive strategy in addressing gaps that have been identified in this study, as well as instituting other relevant measures, such as continuous media engagement and public health interventions relating to genetic counselling. Reforms in other areas that can help reduce the disease burden, include training of practitioners and equipping sickle cell disease treatment centers according to World Health Organization specifications.

show abstract

“…Essentially, nurses may enhance their understanding and management of SCD through accumulated field experience, thereby improving their practice in managing the condition. 25 , 26 Nevertheless, for this knowledge to be translated in practice, health centres must have the necessary equipment for diagnosing SCD. A multisite study in the DRC showed that 85% of the participants, from which the most were physicians, had no access to diagnostic tools of sickle disease.…”

Section: Discussionmentioning

confidence: 99%

Knowledge and practices of sickle cell disease among healthcare providers in Kinshasa, Democratic Republic of the Congo

Ngonde,

Fina,

Burgueno

et al. 2024

African Journal of Primary Health Care & Family Medicine

View full text Add to dashboard Cite

Background: In Kinshasa, Democratic Republic of Congo, there is a low evocation of the diagnosis of sickle cell disease (SCD) by first-level healthcare providers (HCPs), most likely because of poor knowledge of the disease.Aim: To assess the levels of knowledge and practices of SCD and to identify determinants of the practices among primary HCPs.Setting: Healthcare facilities in Selembao health zone in Kinshasa, Democratic Republic of the Congo.Methods: A cross-sectional study of HCPs randomly selected through a two-stage sampling design. Data were collected using a pre-tested interviewer-administered questionnaire. Univariate and bivariate analysis were done to describe the levels of knowledge and practices of SCD. Factors associated with better practices on SCD were determined using multiple linear regression. The threshold for statistical significance was p ˂ 0.05.Results: A total of 318 HCPs, which included 80 physicians and 238 nurses, participated in the study. The participants showed different scores on the components of the knowledge. All the participants showed poor practices on SCD. Multiple linear regression retained overall knowledge of SCD as a significant predictor of better practice for physicians. Knowledge of SCD and duration of work experience were significant predictors of better practices among nurses.Conclusion: The practices of healthcare providers on SCD were far from optimal. These practices were significantly associated with knowledge and experience of healthcare providers.Contribution: This study highlighted the need for continuing professional education to enhance the management of SCD in the setting.

show abstract

Sickle Cell Disease in the Democratic Republic of Congo: Assessing Physicians’ Knowledge and Practices

Cited by 8 publications

References 21 publications

Paediatric sickle cell disease at a tertiary hospital in Malawi: a retrospective cross-sectional study

Paediatric sickle cell disease at a tertiary hospital in Malawi: a retrospective cross-sectional study

A Critical Review of Sickle Cell Disease Burden and Challenges in Sub-Saharan Africa

Knowledge and practices of sickle cell disease among healthcare providers in Kinshasa, Democratic Republic of the Congo

Contact Info

Product

Resources

About