Factors contributing to default among sickle cell patients Komfo Anokye Teaching hospital (Kath), Kumasi, Ghana
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Date
November, 2018
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Abstract
Sickle Cell Disease (SCD) is one of the commonest haemoglobin hereditary disorders in the
world. In sub-Saharan Africa, about 200,000 children are born with this disease annually
contributing significantly to the global burden of disease. The disease is most common in the
Mediterranean regions where there appears to be significant hemoglobinopathies including those
of SCD. Studies done in Ghana show a carrier rare of between 10% to 30%. Children living with
sickle cell disease experience a myriad of complications. The complications can be acute or
chronic resulting in morbidity, increased hospitalisations and mortality. Children with SCD are
supposed to be enrolled in a clinic and reviewed regularly to prevent these complications.
Unfortunately children living with sickle cell are unable to attend these scheduled visits
religiously. In the meantime, reliable data on why they are not able to meet these obligations are
lacking. This research was therefore carried out to pinpoint the factors that contribute to default
for reviews among paediatric SCD patients.
A descriptive cross sectional study was used in this research and it involved the administration of
questionnaires to caregivers and children aged 0-14 years (150 in total) suffering from SCD at
Komfo Anokye Teaching Hospital from April 2018 to June 2018. The questions focused on the
demographic factors and barriers to health care experienced prior to receiving healthcare.
Associations between demographic factors and reasons for not attending clinics on scheduled
dates were tested with Stata software version 13.
Educational and marital status were significant contributing factors to defaulting clinical reviews
with p values of (0.045 and 0.022) respectively, while 50% of study participants had ever
defaulted reviews.. There was a significant influence of family size to default to reviews. The
larger the family size the more likely they were to default reviews (OR 1.40 p-value 0.039).
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There is a less likely for patients who have been admitted more than once to default (OR=0.281
with p-value= 0.122>0.050). High cost of healthcare contributed to default for reviews, (Chisquare= 28.959, p-value 0.000). The causes of admission were anaemic crisis followed by pain
crisis. Health staff related issues such as rude staff, impatient providers and intimidating staff did
not affect default for reviews.
Children living with sickle cell disease need scheduled visits. Therefore caretakers must be
educated continuously to ensure compliance. Sickle cell clinics should be set up in many
hospitals across the country.
Description
A thesis submitted to the Department of Health Policy, Management and Economics, School of Public Health, College of Health Science, Kwame Nkrumah University of Science and Technology, in partial fulfilment of the requirement for the degree of Master of Public Health in Health Policy, Management and Economics.
Keywords
Sickle cell, Patients, (Kath),