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Published on: September 20, 2019
Adherence to prophylaxis and bleeding outcome: A multicenter Nigerian study.
Theresa Ukamaka Nwagha1, Helen Chioma Okoye1, Saleh Yuguda2
1Department of Haematology and Immunology, Southeast Haemophilia Treatment Centre, College of Medicine, University of Nigeria Ituku-Ozalla Campus, Enugu, Nigeria.
Adherence to low-dose prophylaxis in Nigerian children with hemophilia was high (81.0%), but skipping doses correlated with higher bleeding rates. Interventions are crucial for improving treatment outcomes in hemophilia care.
Area of Science:
- Hematology
- Pediatrics
- Public Health
Background:
- Low-dose prophylaxis is standard care for hemophilia in Nigeria, aiming to reduce bleeding and improve quality of life.
- Non-adherence to prophylaxis can hinder achieving optimal outcomes in persons with hemophilia (PWH).
- Evidence on adherence levels and determinants among PWH in Sub-Saharan Africa is limited.
Purpose of the Study:
- To evaluate self-reported adherence to prophylaxis among Nigerian children with hemophilia.
- To identify determinants and predictors of adherence in this population.
- To establish associations between non-adherence, target joint development, and annualized bleed rate (ABR).
Main Methods:
- A cross-sectional survey involving 42 children with hemophilia on low-dose prophylaxis across 5 Nigerian treatment centers.
- Utilized the validated Haemophilia Regimen Treatment Adherence Scale-Prophylaxis (VERITAS-Pro) questionnaire.
- Collected data on target joints and ABR from medical records.
Main Results:
- Overall adherence to prophylaxis was 81.0%.
- The skipping subscale of VERITAS-Pro showed a significant positive correlation with ABR in the non-adherent group (p=0.02).
- Most participants reported good communication with treatment centers.
Conclusions:
- Adherence to prophylaxis in Nigerian children with hemophilia is generally good.
- Skipping doses is a significant factor associated with increased bleeding rates.
- Targeted interventions to improve adherence are essential for better hemophilia management outcomes.
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