Prevention practices influencing frequency of occurrence of vaso-occlusive crisis among sickle cell patients in Abeokuta South Local Government Area of Ogun State, Nigeria

Abstract

BackgroundAfrica is the most affected continent with 200,000 new born affected by sickle cell anemia annually with of 5% of under five deaths. Nigeria has the largest sickle cell gene pool in the world with about 2% of all babies born to Nigerian parents. This study therefore sets out to assess the prevention practices influencing the frequency of occurrence of vaso-occlusive crisis among patients in Ogun State.MethodsThis study is a descriptive cross-sectional study conducted in Abeokuta South Local Government Area Ogun State. A consecutive non randomized sampling of all the sickle cell patients that attend the selected facilities was recruited into the study. Data were collected with the use of questionnaires which were interviewer administered. A total of 415 patients were recruited into the study. Statistical analyses were conducted using SPSS for Windows version 20.0.ResultTwo- third [64.8%] of study participants have crisis twice or more in a month. The frequency of crisis was statistically significantly associated with the age of the child [p = 0.006], use of anti-malaria prophylaxis [p = 0.006], analgesics [p = 0.0001], taking of plenty fluid [p = 0.001] and soothing herbs [p = 0.0001]. Lifestyle factors such as giving balance diet [p = 0.217], restriction from strenuous activities [p = 0.08], and attending Clinic appointments regularly [p = 0.126] were not statistically associated with reduction in the frequency of crisis. Logistic regression analysis shows that predictors of frequent crisis were individuals who were using prophylaxis antimalarial drugs [OR = 0.12, CI = 0.05–0.33] and analgesics [OR = 0.15, C.I = 0.06–0.34].ConclusionThe study reveals that majority of the participants have high frequency of crisis in a month. Drug prophylaxis rather than lifestyle factors may be more important in the prevention of vaso-occlusive crisis among sickle cell patients.Electronic supplementary materialThe online version of this article (doi:10.1186/s12878-017-0077-9) contains supplementary material, which is available to authorized users.

Impact of sickle cell disease on patientsʼ daily lives, symptoms reported, and disease management strategies: Results from the international Sickle Cell World Assessment Survey (SWAY)

“…Findings from SWAY reaffirm results from prior studies showing that VOCs are highly debilitating for patients with SCD, 26,[33][34][35][36] and expands on these findings by reporting the global burden of these acutely painful events and demonstrating the detrimental impact of VOCs on most aspects of patientsʼ daily lives. The self-reported incidence of VOCs in SWAY appears to be higher than in previous reports, 37,38 although a direct comparison of VOC frequency is limited by differing definitions of a VOC and methodologies 36 for capturing their occurrence.…”

“A child with sickle cell disease can't live with just anyone.” A mixed methods study of socio‐behavioral influences and severity of sickle cell disease in northern Nigeria

“…The rates of childhood hospitalization for VOC (73.1%) was similar to other Nigerian centers (61.5%‐64.8%), 25,26 but higher than others (36%‐53.2%) 27,28 . It was also comparable to figures from Asia (73.84%), but higher than the United States (43%‐69%) 29‐31 .…”

“…27,28 It was also comparable to figures from Asia (73.84%), but higher than the United States (43%-69%). [29][30][31] Hospitalization for VOC in the preceding year (41.1%) was also similar to some Nigerian centers, 1,25,26 but lower than others (61.5%-91.6%). 32,33 Likewise, in the United States, one in five children with SCD had ≥3 VOC in the preceding year, while one in four had <3 episodes.…”

“…The rates for blood transfusion in children with SCD (45.7%) were similar to some Nigerian hospitals (39.1%‐39.4%‐51.1%), 1,25,26,28,35 but higher than others (0.5%‐37.6%) 27,32 . The proportion of children with SCD ever transfused was lower in the United Kingdom (1.2%‐19.5%), 36 and the United States (14.2%‐28.8%) 37 .…”

“…The direct relationship between a child's age, hospitalization for VOC, and blood transfusion has been previously reported. 26,32,38,39 Less severe disease in infants and young children could be related to persistent fetal hemoglobin. In contrast, increased physical activities could explain the increased VOC crisis in older children.…”