Risk factors associated with pain episodes among sickle cell patients that visited Mulago Sickle Cell Clinic Kampala Uganda

Abstract

Sickle cell disease (SCD) is a chronic hematologic disease associated with increased morbidity and mortality. The study aims to investigate the suggested socio-economic and clinical factors and their contribution to the frequency of pain episodes among sickle cell patients in Uganda. Using pre-existing secondary data from sickle cell clinic records at Mulago Hospital 2019, the study employed a sample of 2532 sickle cell patients. In support of the outcome being count data, the Negative Binomial Regression model was utilized to estimate how the independent factors affected the frequency of pain episodes among the patients. The factors included sex, age, presence of fever at the pain, presence of other chronic diseases besides Sickle Cell Disease, the intake of hydroxyurea, folic acid, presence of malaria at the pain, presence of fever at the pain, and whether a patient has ever had a transfusion. The frequency of pain episodes was different among age groups as young adults (16/14) experienced the largest number of pain episodes on average that year average (IRR=1.39; 95% CI=1.277-1.522; p=0.000) as compared to young children. While increased temperature (fever) increased the frequency of pain episodes by 24% (IRR=1.243; 95% CI=1.147-1.348; p=0.000), infection by 27% (IRR=1.27; 95% CI=1.191-1.354; p<0.000), other chronic diseases by 11% (IRR=1.11; 95% CI=1.038-1.188; p<0.002), malaria by 38% (IRR=1.38; 95% CI=1.036-1.836; p<0.027), and hydroxyurea however decreased the frequency of pain episodes by 34% (IRR=0.662; 95% CI=0.584-0.750; p<0.000). Sex however did not affect the frequency of pain episodes among sickle cell patients. The study recommends use of hydroxyurea drug since the findings indicate that patients who took it experienced less pain episodes in year. Furthermore, the study recommends massive sensitization on regular medical checkups for SCD patients and more emphasis should be placed on developing Information Education Communication (IEC) materials to educate SCA patients