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, remains 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 a descriptive 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 interviewer-administered questionnaires, featuring both open-ended and dichotomous questions, were meticulously validated, optimized, and employed to gather pertinent data from the participants. The findings revealed that a majority of SCD patients below 15 years in sampled hospitals were female (52.85%), and the highest incidence of SCD occurred in the age range of 0-5 years (46.63%). Educational attainment among patients predominantly peaked at the primary school level (65.80%), with a minimal 7.77% reaching a secondary school level. Moreover, female caregivers (92.23%) were prevalent among those responsible for SCD patients aged 15 years and below. Primary caregivers, aged between 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 out of the sampled SCD patients under 15 years old, a staggering 83.94% experienced crises related to their sickle cell disease, manifesting as abdominal pains for nearly 70 %, joint discomfort for over 72.22%, acute chest pain occurring approximately 25 %, with bone ache accounting about 32 %. Multiple logistic regression analysis demonstrated that female gender, the age group of 6-10 years, and frequent hospital visits (more than twice a month) significantly increased the log odds for 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 holds the potential to enhance the prognosis and wellbeing of both patients and caregivers, and strategic interventions must be devised to improve adherence to treatment protocols for SCD patients aged 15 years and below, thereby enhancing prognosis and overall quality of life.