Factors Associated with Sickle Cell Crisis Among Sickle Cell Disease Patients Aged ≤15 Years in Three Kenyan Health Facilities

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.