TY - JOUR
T1 - Utilization of Pneumococcal Vaccine and Penicillin Prophylaxis in Sickle Cell Disease in Three African Countries
T2 - Assessment among Healthcare Providers in SickleInAfrica
AU - The SickleInAfrica Consortium
AU - Brown, Biobele J.
AU - Madu, Anazoeze
AU - Sangeda, Raphael Z.
AU - Nkya, Siana
AU - Peprah, Emmanuel
AU - Paintsil, Vivian
AU - Mmbando, Bruno P.
AU - Gyamfi, Joyce
AU - Okocha, Chide E.
AU - Asala, Samuel A.
AU - Nembaware, Victoria
AU - Jonas, Mario
AU - Kengne, Andre P.
AU - Chimusa, Emile R.
AU - Nguweneza, Arthemon
AU - Isa, Hezekiah A.
AU - Nnebe-Agumadu, Uche
AU - Adekile, Adekunle D.
AU - Osei-Akoto, Alex
AU - Ohene-Frempong, Kwaku
AU - Balandya, Emmanuel
AU - Nnodu, Obiageli E.
AU - Wonkam, Ambroise
AU - Makani, Julie
N1 - Funding Information:
This study was supported by the National Heart, Lung, and Blood Institute of the National Institutes of Health, Bethesda, MD, USA [U24HL135600 and 1U24HL135881]. All the health care providers who responded to the survey are hereby acknowledged. The Sickle Cell Support Society of Nigeria through which the survey was administered in Nigeria is especially acknowledged. The platform for virtual meetings was supported by SADaCC in South Africa.
PY - 2021/8/6
Y1 - 2021/8/6
N2 - Sickle cell disease is a genetic disease with a predisposition to infections caused by encapsulated organisms, especially Streptococcus pneumoniae. Pneumococcal vaccines and prophylactic penicillin have reduced the rate of this infection and mortality in sickle cell disease. However, implementation of these interventions is limited in Africa. The objectives of the study were to assess health care providers’ behaviors with the implementation of pneumococcal vaccination and penicillin prophylaxis and to identify barriers to their use. A 25-item online questionnaire was administered through SickleinAfrica: a network of researchers, and healthcare providers, in Ghana, Nigeria, and Tanzania, working to improve health outcomes of sickle cell disease in Africa. Data was collected and managed using the Research Electronic Data Capture (REDCap), tools and data analysis was done using STATA version 13 and R statistical software. Eighty-two medical practitioners responded to the questionnaire. Only 54.0 and 48.7% of respondents indicated the availability of published guidelines on sickle cell disease management and pneumococcal vaccine use, respectively, at their facilities. The majority (54.0%) perceived that the vaccines are effective but over 20.0% were uncertain of their usefulness. All respondents from Ghana and Tanzania affirmed the availability of guidelines for penicillin prophylaxis in contrast to 44.1% in Nigeria. Eighty-five percent of respondents affirmed the need for penicillin prophylaxis but 15.0% had a contrary opinion for reasons including the rarity of isolation of Streptococcus pneumoniae in African studies, and therefore, the uncertainty of its benefit. Lack of published guidelines on the management of sickle cell disease and doubts about the necessity of prophylactic measures are potential barriers to the implementation of effective interventions.
AB - Sickle cell disease is a genetic disease with a predisposition to infections caused by encapsulated organisms, especially Streptococcus pneumoniae. Pneumococcal vaccines and prophylactic penicillin have reduced the rate of this infection and mortality in sickle cell disease. However, implementation of these interventions is limited in Africa. The objectives of the study were to assess health care providers’ behaviors with the implementation of pneumococcal vaccination and penicillin prophylaxis and to identify barriers to their use. A 25-item online questionnaire was administered through SickleinAfrica: a network of researchers, and healthcare providers, in Ghana, Nigeria, and Tanzania, working to improve health outcomes of sickle cell disease in Africa. Data was collected and managed using the Research Electronic Data Capture (REDCap), tools and data analysis was done using STATA version 13 and R statistical software. Eighty-two medical practitioners responded to the questionnaire. Only 54.0 and 48.7% of respondents indicated the availability of published guidelines on sickle cell disease management and pneumococcal vaccine use, respectively, at their facilities. The majority (54.0%) perceived that the vaccines are effective but over 20.0% were uncertain of their usefulness. All respondents from Ghana and Tanzania affirmed the availability of guidelines for penicillin prophylaxis in contrast to 44.1% in Nigeria. Eighty-five percent of respondents affirmed the need for penicillin prophylaxis but 15.0% had a contrary opinion for reasons including the rarity of isolation of Streptococcus pneumoniae in African studies, and therefore, the uncertainty of its benefit. Lack of published guidelines on the management of sickle cell disease and doubts about the necessity of prophylactic measures are potential barriers to the implementation of effective interventions.
KW - Behaviors
KW - penicillin prophylaxis
KW - sickle cell disease
KW - Sickle Pan-African Research Consortium (SPARCO)
UR - http://www.scopus.com/inward/record.url?scp=85112054909&partnerID=8YFLogxK
U2 - 10.1080/03630269.2021.1954943
DO - 10.1080/03630269.2021.1954943
M3 - Article
SN - 0363-0269
VL - 45
SP - 163
EP - 170
JO - Hemoglobin
JF - Hemoglobin
IS - 3
ER -
