Dissertation (MSc Pediatric Nursing)
Sickle cell disease is a blood disorder which has become very common today. Tanzania is fourth in the world with the highest Sickle cell disease birth rates (Piel et al., 2013). Between 7800 and 11,000 children with Sickle cell disease are born in Tanzania every year (Makani et al., 2018). Despite all the efforts, there is an increasing number of hospital admissions of children with sickle cell disease complications, and it is not known if caregivers have competence on prevention of sickle cell disease complications. This study aimed to assess caregivers competence in the prevention of sickle cell complications among children attending SCD clinics in Dodoma region.
A cross-sectional analytical study was done involving 385 caregivers with SCD children in Dodoma region. A simple random sampling technique was used to recruit study participants. Data were obtained through semi-structured questionnaires and documentary review. SPSS version 25 was used for data analysis. Chi-square test was used to determine relationship between variables and variables with p-value of <0.05 at 95% CI were considred significant and were retained for binary logistic regression analysis to assess association between independent and dependent variables.
In this study, 385 caregivers were included. Majority of them 383 (99.48%) were female with the ages ranging from 19 to 53, the mean age of 34.44 with ± 8.12. The sex of the children was approximately equally distributed, 51% were male and 49% were female. The mean age of children was 5.61 ± 2.98 years. Majority of the caregivers, 54% had adequate knowledge on sickle cell disease and its related complications, 55% had appropriate practice, and 70% had positive attitude on the prevention of sickle cell disease complications. Almost all caregivers included in the study had perceived barrier on preventions of sickle cell disease complications, 2.6% experienced one barrier, 12.7% experienced two barriers, 30.65% had three perceived barriers, 29.87% had four perceived barriers and 23.64% of them experienced five perceived barrier on the prevention of sickle cell disease complications.
Sociodemographic characteristics after were adjusted in the full mode for caregivers knowledge, practice and attitude: respondents with secondary education and above (AOR = 0.272, 95% CI: 0.097, 0.761, p = 0.0381), no formal education (AOR = 0.945, 95% CI: 0.574, 1.557, p = 0.8253), inadequate knowledge (AOR = 0.260, 95% CI: 0.1561, 0.426, p<.0001) were the predictors for associated with complications of sickle cell disease. Besides, caregivers with primary education (AOR = 1.66, 95% CI 1.062, 2.613, p = 0.0262) and those with secondary level of education and above (AOR = 13.24, 95% CI, 3.762, 46612, p <.0001) were significantly associated with their knowledge on the preventions of SCD complications. Moreover, having secondary level and above (AOR = 4.85, 95% CI: 1.555, 15.098, p = 0.0065), and single caregivers (AOR = 0.59, 95% CI: 0.382, 0.900, p = 0.0147) were the only predictors for caregivers practice on the prevention of SCD complications among children attending SCD clinic.
This study showed that the highest proportion of caregivers living with children having sickle cell disease were having inadequate level of knowledge on SCD related complications, prevalence of practices showed that there are appropriate practices on prevention of SCD complications. Inadequate knowledge of caregivers on SCD disease knowledge raises some questions on the quality of health educations provide to caregivers during clinics visits.