Perceived stigma among adolescents with sickle cell anemia in a tertiary health facility

Abstract

Background Adolescents with sickle cell anemia (SCA) are challenged by a myriad of complex psychosocial issues, which may be triggered or exacerbated by stigmatization. The magnitude of childhood stigma is scarcely being assessed, as more focus is often given to the physical symptoms and signs of SCA. This study sought to assess the prevalence of perceived stigma and its associated factors among adolescents with SCA in steady state. Patients and methods Using a cross-sectional design, 200 adolescents with SCA (patients) were recruited consecutively from the Paediatric Haematology Clinic. Controls matched for age, sex, and socioeconomic class, with hemoglobin genotype AA or AS, were recruited from the Children Outpatient Clinic. A self-administered questionnaire was used to obtain the clinicodemographic data. A validated perceived stigma scale was used in this study. Bivariate and multivariate analyses were performed at 0.05 significant level. Results There were 97 (48.5%) males and 103 (51.5%) females in each group. Perceived stigma was present in 159 (79.5%) patients and 16 (8.0%) controls (P=0.001). Perceived stigma was significantly higher among patients who were in their early and mid-adolescence, those who had sickle cell pain crises frequency of greater than thrice a year, and those with poor self-perception. Patients in early and mid-adolescence were about three times more likely to experience perceived stigma than those in late adolescence (odds ratio=2.9; 95% confidence interval=1.1–7.7; P=0.031). Conclusion Stigma is a major problem among adolescents with SCA. Regular screening for stigma is recommended for patients with SCA, especially those in early and mid-adolescence.