Date of Conferral

2022

Degree

Ph.D.

School

Public Health

Advisor

Sriya Krishnamoorthy

Abstract

AbstractThe case fatality rate among children living with sickle cell disease was approximately 50% to 90% in Sub-Saharan Africa. Though researchers have contributed social determinants of health more broadly, they have not provided adequate screening information on children living with sickle cell disease aged 6 months to 59 months. The purpose of this cross-sectional study was to examine the association between sickle cell disease status, infection prevention, pain and anemia management, demography, socioeconomic status, and healthcare use. This study included approximately 11,536 genotype results of children under 5-years-old in Nigeria. Bronfenbrenner’s systems theory and Krieger’s ecological theory formed the theoretical frameworks in this study. The 2018 Nigeria Demographic and Health Survey data were analyzed using binary logistic regression. Statistically significant positive associations were found between sickle cell disease status and variables such as a child’s age (p = .022); children’s hemoglobin (p = .034); mother’s uptake of children’s genotype testing (p < .001); living in Northcentral Nigeria (p = .047); Southeast Nigeria (p = .008); or South Nigeria (p = .011); and having Yoruba ethnicity (p = .036). These findings enable evidence-based approaches in the clinical management of sickle cell disorders in Nigeria. For example, the Federal Ministry of Health may prioritize early screening of sickle cell hemoglobin in all six geopolitical zones of Nigeria with heightened focus in the areas that were found to be statistically significant. The positive social implication includes improved community knowledge on prevention and control of childhood sickle cell disease. Future research is needed in the field of vaccine hesitancy and childhood sickle cell disorders in Nigeria.

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