Current sickle cell disease management practices in Nigeria

Area of Science:

• Hematology
• Public Health
• Clinical Medicine

Background:

• Nigeria has the highest global burden of sickle cell disease (SCD).
• Standard-of-care practices for SCD patients in Nigeria are poorly utilized.
• Significant disparities exist in SCD management across the country.

Purpose of the Study:

• To document available facilities and common management practices in Nigerian SCD clinics.
• To assess the current state of sickle cell disease care in Nigeria.
• To identify areas for improvement in SCD patient management.

Main Methods:

• A questionnaire survey was conducted among doctors in dedicated SCD clinics in Nigeria.
• Data collected focused on clinic resources and patient management protocols.
• The survey aimed to provide a snapshot of SCD care delivery.

Main Results:

• 18 clinics across 11 institutions participated, managing varying patient loads.
• Routine malaria and folic acid prophylaxis were common; penicillin prophylaxis and hydroxyurea use were limited.
• Diagnostic capabilities varied, with access to electrophoresis but underutilization of HPLC; newborn screening is absent.

Conclusions:

• SCD care in Nigeria remains suboptimal, necessitating urgent, concerted efforts.
• Improving the impact on the disease burden requires greater focus on primary care.
• Specific strategies are needed to enhance SCD management at all levels of care.