Penicillin V prophylaxis uptake among children living with sickle cell disease in a specialist sickle cell clinic in Ghana: A cross-sectional study.
Penicillin V prophylaxis uptake among children living with sickle cell disease in a specialist sickle cell clinic in Ghana: A cross-sectional study.
复制标题
作者：
青霉素V预防可以保护患有镰状细胞病(SCD)的儿童免受细菌感染，特别是肺炎链球菌的感染。然而，在SCD患者中，青霉素V预防的摄取率很难评估，而且往往很差。因此，本研究试图采用尿液测定法和自评法调查SCD儿童口服青霉素V预防依从性及其相关因素。这项研究采用分析性横断面设计，同时使用尿液分析和自我报告的方法来评估青霉素V预防依从性。采用多元Logistic回归分析青霉素V预防依从性的相关因素。P值 <； 被认为具有统计学意义。在纳入的421例SCD患者中，客观和主观评价方法的青霉素V预防依从性分别为30.0%和68.0%。对于客观评估方法，由祖父母照顾增加了青霉素V依从性的几率(调整后的优势比[AOR] = 3.68，可信区间[CI] = 1.03-13.15)。而10~14岁的慢性阻塞性肺疾病患者(AOR = 0.36，CI = 0.17~0.80)，>；14年(AOR = 0.17，CI = 0.05~0.61)，已婚照料者/父母照顾(AOR = 0.32，CI = 0.14~0.72)，离异照顾者/父母照顾(AOR = 0.23，CI = 0.07~0.75)，服用自制中药制剂治疗SCD(AOR = 0.42，CI = 0.21~0.83)，不适当的青霉素V预防用药(AOR = 0.2 7，CI = 0.11~0.6 7)降低了青霉素V依从性。在主观评价方法上，服用治疗SCD的自制制剂(AOR = 为0.5 2，CI = 为0.30~0.89)和不适当的青霉素V摄入(AOR = 为0.32，CI = 为0.17~0.60)可降低青霉素V的依从率。这项研究报告了患有SCD的儿童中青霉素V预防的依从率相对较低。对SCD患者和/或护理人员进行教育和咨询，使他们认识到需要坚持青霉素V预防，可以预防因不坚持而可能出现的并发症。
Penicillin V prophylaxis protects children living with sickle cell disease (SCD) from bacteria infections especially Streptococcus pneumonia. However, the uptake of penicillin V prophylaxis is difficult to assess and often poor among SCD patients. Therefore, this study sought to investigate oral penicillin V prophylaxis adherence among SCD children using urine assay and self‐reported methods and the associated factors. The study employed an analytical cross‐sectional design in the assessment of penicillin V prophylaxis adherence using both urine assay and self‐reported methods. Multiple logistic regression analysis was used to determine the factors associated with penicillin V prophylaxis adherence. A p value < 0.05 was considered statistically significant. Among the 421 SCD patients recruited, penicillin V prophylaxis adherence was observed to be 30.0% and 68.0% for the objective and subjective methods of assessment, respectively. For the objective method of assessment, being cared for by grandparents increased the odds of penicillin V adherence (adjusted odds ratio [aOR] = 3.68, confidence interval [CI] = 1.03–13.15). However, SCD patients within the ages of 10–14 years (aOR = 0.36, CI = 0.17–0.80), >14 years (aOR = 0.17, CI = 0.05–0.61), SCD patient cared for by married caregivers/parents (aOR = 0.32, CI = 0.14–0.72), SCD patient cared for by divorced caregivers/parents (aOR = 0.23, CI = 0.07–0.75), SCD patients taking homemade (herbal) preparations for the treatment of SCD (aOR = 0.42, CI = 0.21–0.83), and inappropriate intake of penicillin V prophylaxis (aOR = 0.27, CI = 0.11–0.67) reduced the odds of penicillin V adherence. For the subjective method of assessment, taking homemade preparation (herbal) for the treatment of SCD (aOR = 0.52, CI = 0.30–0.89) and inappropriate intake of penicillin V (aOR = 0.32, CI = 0.17–0.60) reduced the odds of penicillin V adherence. This study reports a relatively low adherence rate of penicillin V prophylaxis among children living with SCD. Educating and counseling both SCD patients and/or caregivers on the need to be adherent to penicillin V prophylaxis could prevent complications that may arise from nonadherence.