Knowledge, beliefs, attitudes, and behaviors regarding sickle cell disease: Implications for prevention

Endline assessment of knowledge about sickle cell disease among the tribal community of Chhotaudepur district of Gujarat

Sickle cell disease (SCD) is a significant public health concern in India, with one of the highest disability burdens worldwide. For the success of the disease prevention and control program that aims to reduce prevalence through health promotion and screening, the public's prior knowledge of the disease is important. Hence, this study was conducted to assess baseline knowledge of the disease and effects of health education and community mobilization program in the SCD endemic tribal community of Gujarat. This quasi-experimental study was conducted in three phases at Chhotaudepur district of Gujarat, India. Knowledge of the community was assessed through the administration of pretested quantitative questionnaire in 1646 and 1631 individuals respectively during formative and evaluation phases. Differences between the proportions of two phases were statistically assessed by chi-square tests. Despite 75.3% of respondents having heard of SCD before, only 20% could perceive the correct cause. It was improved by 42% post-intervention. During the evaluation, 83% respondents recognized the most common symptom of extreme pain, whereas 86.8% identified the correct diagnostic method. Seventy-seven percent respondents reported modern medicine as a treatment for SCD at endline. Knowledge and awareness about SCD were found inadequate in the community. However, health education intervention strategies effectively improved knowledge related to the disease and its causes, diagnosis, and treatment. Hence, urgent action is required to incorporate community mobilization and awareness generation strategies to mitigate the disease burden.

Knowledge and perception related to sickle cell disease among tribal community, India: A mixed-method study

BACKGROUND

Sickle cell disease (SCD) is a public health problem. In absence of a pan-country intervention program in India, SCD prevalence is ascending without control. Since knowledge and perception of a community is a prerequisite for developing an intervention strategy, the current study was designed to assess it in a high SCD burden tribal-dominated district of Odisha.

METHODS

A mixed-method study combining qualitative and quantitative methods was conducted in the Kandhamal district, Odisha, India. A cross-sectional survey was conducted among randomly selected 1600 individuals, using a pre-tested questionnaire and 26 in-depth interviews were conducted with key informants.

RESULTS

Although 74.2% of the participants in the studied area had heard about the disease, only 13.6% know the cause of the disease. 69% had the knowledge to opt for modern medication. However, treatment compliance was poor, patients resort to using medications only during the crisis stage. Individuals who had knowledge about disease aetiology got to know about SCD from lived experiences of themselves, close relatives, or villagers and rarely from health workers. The community members had no clarity regarding which health centre to be approached for routine medication and management of SCD crisis.

CONCLUSION

The area is endemic for SCD, yet, the community lacks knowledge about the cause and treatment modality of the disease. In addition, currently there is no government-run intervention programme for screening and management of SCD related morbidity. Hence, a community based intervention strategy needs to be implemented urgently for enhancing the knowledge, perception, and aptitude related to SCD.

Inadequate community knowledge about sickle cell disease among the Indian tribal population: a formative assessment in a multicentric intervention study

BACKGROUND

Sickle cell disease (SCD) is a serious public health problem, with >300 000 affected births worldwide each year. About 73% of the SCD-affected people in India belong to the tribal population. The Government of India is planning to implement a programme for SCD and hence people's knowledge of SCD is crucial. This paper reports the SCD-related knowledge among the Indian tribal population.

METHODS

As part of a formative assessment before an intervention, data were collected from 9837 adults from 24 primary health centre areas of six states. Each community's knowledge of SCD was elicited through an interviewer-administered pretested questionnaire. Univariate and multivariate analyses were conducted.

RESULTS

Overall, 32.1% (CI 31.2 to 33.1%) of participants had heard of SCD, 7.9% (CI: 7.3 to 8.4%) knew that SCD is hereditary, 19.4% (CI: 18.7 to 20.3%) knew that a blood test can diagnose SCD and 23.9% (CI: 23.1 to 24.8%) knew that SCD is treatable. Only 13.1% (CI: 12.4 to 13.8%) knew that SCD can be prevented. No more than 16% knew about any SCD symptoms. Multiple logistic regression revealed some predictors of basic knowledge (i.e. had heard of SCD).

CONCLUSIONS

There is a gross inadequacy of knowledge about SCD in the Indian tribal population. This study warrants implementing a health education programme as a part of the SCD programme.

Health beliefs as a predictor of screening behaviors among college students

Twenty million people live with a sickle cell disease (SCD) diagnosis globally; about 100,000 reside in the United States of America (US). Although SCD continues to threaten the health, mostly of particular groups in the US, there is a lack of knowledge on risk factors such as unawareness of carrier status, inheritance patterns, and resistance to SCT screening among childbearing age individuals. A cross-sectional survey design using a modified version of the Health Belief Survey assessed college students' SCD beliefs and screening behaviors. Four hundred sixteen students from a North Texas university campus participated in the survey. Although most participants believed that knowing their carrier status was important, only 26% were aware of their status. Findings demonstrated that health beliefs were a significant predictor of screening behaviors. The Universal, Selective, and Indicated Prevention Approach was suggested as a suitable approach to educate, transform health beliefs, and augment screening participation.

Sickle cell disease in Grenada: Quality of life and barriers to care

BACKGROUND

Grenada is a small, resource-limited Caribbean country with a high incidence of sickle cell disease (SCD). Since little is known about the challenges facing individuals living with SCD in the West Indies, we sought to assess barriers to healthcare and the impact of SCD on quality of life in Grenada.

METHODS

Both adults aged 18+ (n = 19) and caregivers of children aged 2-17 (n = 26) completed validated survey measures regarding barriers to care and quality of life, along with a genetics knowledge questionnaire. Caregivers also completed a caregiver burden scale. Survey scores were calculated, and responses were analyzed for an association between demographic variables.

RESULTS

The Barriers to Care Questionnaire, in which lower scores indicate more barriers, revealed that both adults (mean = 69.9) and children (mean = 75.5) with SCD experienced reduced access to care. The Adult Sickle Cell Quality of Life Measurement Information System indicated increased depression and loneliness in adults, with the lowest scores in the Emotional subscale. However, the Pediatric Quality of Life Inventory answered by caregivers of children with SCD showed the lowest scores in the Physical Functioning subscale. Further analysis using the Caregiver Burden Scale-Zarit Burden Interview revealed that 53.8% of caregivers of children with SCD indicated "little to no burden," which may reflect a difference in cultural expectations of a caregiver between high-income countries and Grenada. Finally, ~80% of respondents knew that SCD was a genetic condition; however, 61%-84% could not correctly indicate recurrence risks, demonstrating a need for additional education.

CONCLUSION

These data provide new insights regarding the experience of living with SCD in Grenada and support the need for further investigations into specific barriers to healthcare delivery, which could also improve education and well-being for those affected by SCD in Grenada and in the broader Caribbean community.