Assessment of depression in children and adolescents with sickle cell anemia in a low-resource setting: a comparative study.

Children with sickle cell anemia (SCA) usually face psychological complications especially depression. Assessment of depression in resource-limited settings may help identify the extent to which the children with SCA in such settings may need its introduction as part of routine care. This study aimed to assess depression in children and adolescents with SCA in a low-resource setting. This cross-sectional observational study involved 84 children and adolescents with SCA aged 7-17 years who were selected using a systematic random sampling technique. Their controls were 84 age- and sex-matched individuals with AA hemoglobin genotype. A structured questionnaire was used to collect socio-demographic data while depression was assessed with the Children's Depression Inventory. The prevalence of depression was non-significantly higher in subjects compared to the controls (8.3% vs. 2.4%) (Fisher's χ2 = 1.88, p = 0.171). Though not statistically significant, the subjects had 3.7 times higher odds of having depression compared to the controls (OR = 3.7; 95% CI 0.75-18.50; p = 0.107). Of the 5 depression subscales, the subjects had a significantly higher difference in the negative mood (p = 0.042). Despite the comparable prevalence of depression with their normal controls, children and adolescents with SCA had a higher negative mood and higher odds of having depression than normal individuals. Thus, there is a need for the introduction of depression assessment as a complement to routine care of these children with SCA in resource-poor settings.

Clinical profile and home management of sickle cell-related pain: the Enugu (Nigeria) experience.

OBJECTIVE: To document the pattern of and ability of sickle cell anemic patients to manage painful crises at home. SUBJECT AND METHODS: Confirmed HbSS patients or caregivers attending the University of Nigeria Teaching Hospital (UNTH), Enugu, Nigeria, were interviewed, using a questionnaire, on their last painful episode. RESULTS: The limbs were involved in all ages, but involvement of the joints, ribs, and spine was uncommon in patients under 5 years old. Pain started between 6 pm and 12 midnight in 33.3%. Analgesics with or without massage or hydration was mostly used at home. 29% of subjects required hospitalization. CONCLUSION: Patients need better access to more potent analgesics to reduce the burden on the health system.