Current sickle cell disease management practices in Nigeria
Current sickle cell disease management practices in Nigeria
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DOI：
10.1093/inthealth/iht022
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发表时间：
2014-03-01
影响因子：
2.5
通讯作者：
Adekile, A. D.
中科院分区：
文献类型：
--
作者：
Galadanci, N.;Wudil, B. J.;Adekile, A. D.
虽然尼日利亚的镰状细胞病（SCD）的负担是世界上最高的，但该国SCD患者的标准护理实践仍然存在变化和利用率低下的问题。这是一项对尼日利亚一些专门的SCD诊所的医生进行的问卷调查，以记录可用的设施和常见的管理实践。来自11个机构的18个诊所的答复。每个中心接受随访的患者数量范围为15至约11000例。所有诊所都定期向病人提供疟疾预防和叶酸。只有8家诊所开青霉素预防。八个处方羟基脲的病人谁可以负担得起的指示。除三个中心外，所有中心都有电子细胞计数器，但都可以使用血红蛋白电泳。三个国家安装了高性能液相色谱仪，但没有一个是常规使用的。一个机构有一个正常运作的分子生物学实验室。该国没有正式的新生儿筛查方案。所有人都可以进入微生物学和化学实验室。九个机构有CT，六个有MRI和三个有经颅多普勒facility.The护理可用于SCD在尼日利亚仍然是次优的，有迫切需要协调一致的努力来解决这个问题，但要对疾病的负担产生重大影响将需要更多的关注在初级保健水平。概述了实现这一目标的一些步骤。
Although Nigeria has the highest burden of sickle cell disease (SCD) worldwide, there is still variable and poor utilisation of standard-of-care practices for SCD patients in the country.This was a questionnaire survey of doctors in some dedicated SCD clinics in Nigeria in order to document the facilities available and common management practices.There were responses from 18 clinics based in 11 institutions. The number of patients being followed in each centre ranged from 15 to approximately 11 000. All clinics provided malaria prophylaxis and folic acid routinely to their patients. Only eight clinics prescribe penicillin prophylaxis. Eight prescribe hydroxyurea to patients who can afford it when indicated. All of the centres except three have electronic cell counters, but all had access to haemoglobin electrophoresis. Three had high-performance liquid chromatography machines installed but none was being routinely used. One institution had a functioning molecular biology laboratory. There is no official newborn screening programme in the country. All had access to microbiology and chemistry laboratories. Nine institutions had CT, six had MRI and three had transcranial Doppler facilities.The care available for SCD in Nigeria is still suboptimal and there is an urgent need for concerted effort to tackle the problem, but to make a significant impact on the burden of the disease would require more focus at the primary care level. Some steps to achieving this are outlined.