镰状细胞病:尼日利亚拉各斯一家三级医院急诊儿童护理人员的认识和表型分布

E. Oluwole, T. Adeyemo, B. Osinaike, P. Akintan
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背景:镰状细胞病在撒哈拉以南非洲的发病率和死亡率很高,预计到2050年,这一负担将进一步增加。众所周知,尼日利亚是世界上镰状细胞病负担最重的国家,约有2.69-5%的人口受该疾病影响。目的:本研究确定护理人员对镰状细胞病的认识和尼日利亚拉各斯大学教学医院(LUTH)儿童急诊儿童的表型分布。方法:本研究采用横断面和描述性设计,采用预先测试的结构化访谈问卷收集250名护理人员和儿童的数据。使用haemtypesc™快速检测试剂盒检测在护理人员同意下连续招募的应答者的全血血红蛋白表型。使用Statistical Package for Social Sciences第21版软件进行分析。单因素和双因素分析均以p≤0.05的显著性水平进行。结果:患儿平均年龄为50.27±50.91个月。女性141例(56.4%)多于男性。几乎所有242名(96.8%)看护者都不知道儿童的Hb表型。HbAA患儿173例(69.2%),HbAA患儿55例(22.0%);HbAC 6例(2.4%);HbSS和hbscphenotype分别为15例和1例(6.0%和0.4%)。护理人员对SCD的认知程度与教育程度有统计学意义(p=0.002),对SCD的认知程度与预防知识有统计学意义(p<0.001)。结论:儿童监护人员对SCD的认知度较高,但大多数监护人员并不了解儿童的Hb表型。多数患儿为HbAA,且HbSS和HbSC表型比例较高。尼日利亚强烈建议进行常规新生儿/早期婴儿SCD筛查,以早期诊断和预防SCD并发症。
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Sickle cell disease: caregiver’s awareness and phenotype distribution among children presenting to children emergency of a tertiary hospital in Lagos, Nigeria
Background: Sickle cell disease accounts for significant morbidity and mortality in sub-Saharan Africa and the burden is expected to increase further by 2050. Nigeria is known to bear the highest burden of sickle cell disease in the world with about 2.69–5% of the population affected by the disease.Aim: This study determined awareness of sickle cell disease among caregivers and phenotype distribution of children presenting to children emergency in Lagos University Teaching Hospital (LUTH), Nigeria.Methods: The study was crosssectional and descriptive in design and data was collected using a pretested, structured intervieweradministered questionnaire among 250 caregivers and children. HemoTypeSC™ rapid test kit was used to determine the hemoglobin  phenotype in whole blood of the respondents who were consecutively recruited following the caregiver’s consent. The Statistical Package for Social Sciences version 21 software was used for analysis.Univariate and bivariate analyses were carried out with a level of significance set at p ≤ 0.05.Results: The mean age of the children was 50.27±50.91 months. There were more females 141 (56.4%) than males. Almost all 242 (96.8%) caregivers did not know the children’s Hb phenotype. Most 173 (69.2%) of the children had HbAA;55(22.0%) were HbAS; 6(2.4%) were HbAC; 15 and 1 (6.0% and 0.4%) were HbSS and HbSCphenotypes respectively. Education was statistically significant with awareness of SCD (p=0.002) and awareness of SCD was statistically significant with knowledge of prevention (p<0.001) among the caregivers.Conclusion: Awareness of SCD among the caregivers of children was high, although the majority of them did not know the children’s Hb phenotype. Most of the children had HbAA with a high proportion of HbSS and HbSC phenotypes. A routine neonatal/early infant screening program for SCD is highly recommended in Nigeria for early diagnosis and prevention of SCD complications.
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