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Published on: July 4, 2018
Risk factors associated with pain episodes among sickle cell patients that visited Mulago National Referral
Nassiwa Shamira1, Asiimwe John Bosco2, Nsimbe Dick1
1Department of Statistical Methods & Actuarial Sciences, School of Statistics & Planning, College of Business & Management Sciences, Makerere University, Kampala, Uganda.
Background:
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.
Method:
We used pre-existing secondary data from sickle cell clinic records at Mulago referral hospital collected in 2019, with 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.
Results:
The frequency of pain episodes was different among age groups as age group (16/24) experienced the highest number of pain episodes on average (Incidence Rate Ratio = 1.39; 95% CI = 1.277-1.522; p = 0.000) compared to young children because as individuals age, pain management declines, and repeated episodes can lead to increased sensitivity, making them more prone to pain. While increased temperature (°C) (fever) increased the frequency of pain episodes by 24% (Incidence Rate Ratio = 1.243; 95% CI = 1.147-1.348; p = 0.000), infection by 27% (Incidence Rate Ratio = 1.27; 95% CI = 1.191-1.354; p < 0.000), other chronic diseases by 11% (Incidence Rate Ratio = 1.11; 95% CI = 1.038-1.188; p < 0.002), malaria by 38% (Incidence Rate Ratio = 1.38; 95% CI = 1.036-1.836; p < 0.027). The rate of hydroxyurea usage was very high at 90%. The intake of the drug reduced the frequency of pain episodes by 34% (Incidence Rate Ratio = 0.662; 95% CI = 0.584-0.750; p < 0.000). According to the observations, there is a high chance that hydroxyurea also had a strong protective against malaria in SCD patients. Nevertheless, there was no evidence that being a male or female would influence the frequency of pain episodes among sickle cell patients.
Conclusions:
These findings are expected to add to the body of knowledge in the health sector, assist in advocacy programs, inform policy, and aid in tailored interventions.
