Unravelling the clinical practice of Nigerian doctors in the management of sickle cell anaemia: an in-depth cross-sectional survey
Background: Multidisciplinary management of sickle cell disease (SCD) is the cornerstone of comprehensive care designed to provide appropriate intervention to prevent or delay the development of multiorgan dysfunction associated with this disorder. This treatment approach involves a wide range of activities geared towards early detection and active management of this disease related organ-system deficit. Available research shows that the mortality rate in SCD is still high, mostly due to poor access to health and lack of comprehensive care management programmes across the board. The aim of this study is to determine the practice of comprehensive care for SCD among Physicians in Nigeria.
Methods: This was a cross-sectional descriptive multistage study involving one teaching hospital in 6 geopolitical zones of Nigeria. A structured questionnaire of four sessions of demographic, place of comprehensive care, investigations routinely prescribed to patients and referral habits of physicians was used.
Results: A total of 375 complete responses received were analysed. The man age was 42±6 years. About half of the respondents were Consultants 169 (45.1%), Haematologists 85(22.7%) and work in tertiary health centres (66.1%). About half of the respondents do not regularly order routine research (54.5%).
Conclusion: A significant proportion of physicians prescribe folic acid and proguanil but less commonly hydroxyurea. Similarly, an abysmal low proportion of participants regularly request for test to detect organ damage. As there are many specialities and categories of physicians involved in SCD patients so is their approach to treatment because guidelines and framework that are embedded within comprehensive care system are not followed by all categories of attending doctors.
Keywords: Clinical practice, doctors, sickle cell disease, comprehensive care
