Preventive measures of vaso-occlusive crisis among sickle cell disease patients in South-Eastern Nigeria: How much do our patients know?

Abstract

Background: Vaso-occlusive crisis (VOC) is a feature of sickle cell disease (SCD), an inherited medical condition which is more common in Sub-Saharan Africa especially Nigeria and is saddled with multi-systemic complications. Knowledge and practice of preventive measures of VOC by patients may reduce the risk of morbidity and mortality. Aim: The purpose of this manuscript is to determine the knowledge, attitude, and practice of the various preventive measures of VOC by patients and their relationship with their frequency of painful crisis. Materials and Methods: A cross-sectional descriptive survey was used. This study was conducted between August, 2018, and February, 2019. Participants were selected consecutively as they came for clinic consultations. Demographic characteristics and the knowledge, attitude, and practice of various preventive measures of VOC were obtained using a structured interviewer-administered questionnaire. The analysis was performed using Statistical Package for the Social Sciences software version 23.0. Descriptive and inferential statistics were used with P < 0.05 which was considered statistically significant. Ethical clearance and informed consent were obtained before the commencement of the study. Results: A total of 154 SCD patients participated in the study and were made up of 73 (47.4%) males and 81 (52.6%) females, with a male-to-female ratio of 1: 1.1. Majority of the respondents (76.6%) had good knowledge of preventive measures toward VOC in SCD. This study also found that 59 (38.3%) participants had good practice of preventive measures toward VOC while 95 (61.7%) had fair practice. Majority (68% [40/59]) of those who had good practice of preventive measures were less likely to have more than three crises in a year compared to those who do not practice good preventive measures, though not statistically significant (OR = 2.489, P = 0558) (confidence interval = 0.480 – 0.637). Conclusion: Majority of the patients have good knowledge and practice of preventive measures of VOC and this appears to have reduced the frequency of their crisis in a year. Health education for sickle cell patients is an important tool that may reduce morbidity and mortality by reducing the frequency of crisis.