Abstract:
In view of the dearth of definitive therapeutic measures for sickle cell disease (SCD) and its
associated crises, the resulting financial burden on parents and caregivers, coupled with
psychological distress, social stigma, and other far-reaching consequences, is still incalculable. This
research assessed the determinants of sickle cell crises among individuals with SCD aged 15 years
and below, focusing on three healthcare facilities in Nairobi County. Using an analytical cross
sectional design, the study aimed to establish the correlation between SCD crises and various
variables in this specific age group within the selected health facilities. Structured questionnaires
administered by the interviewer, featuring open and dichotomous questions, were meticulously
validated, optimized, and used to collect pertinent data from the participants. The findings
revealed that most patients with SCD under 15 years of age in the hospitals sampled were women
(52.85%), and the highest incidence of SCD occurred in the age range of 0-5 years (46.63%).
Educational attainment among patients reached its peak at the primary school level (65.80%), with
a minimal 7.77% reaching the secondary school level. Furthermore, female caregivers (92.23%)
were prevalent among those responsible for patients with SCD under 15 years of age. Primary
caregivers aged 26-30 years (37.82%) and 31-35 years (26.42%) were predominately married
(75.13%) and engaged in agricultural activities (63.73%). This study revealed that of the patients
with SCD under 15 years of age sampled, a staggering 83.94% experienced crises related to their
sickle cell disease, manifesting as abdominal pains for nearly 70 %, joint discomfort for more than
72.22%, acute chest pain occurring approximately 25 %, with bone ache accounting about 32 %.
Multiple logistic regression analysis showed that the gender, age group of 6-10 years and frequent
hospital visits (more than twice a month) significantly increased the odds ratio of severe SCD crises.
Therefore, this study underscores the impact of patient and caregiver factors on the severity of
SCD and its crises. Modifying these factors appropriately has the potential to improve the
prognosis and well-being of both patients and caregivers, and strategic interventions must be
devised to improve adherence to treatment protocols for patients with SCD aged 15 years and
under, thus improving the prognosis and overall quality of life.
