Knowledge and Utilisation of Hydroxyurea among Patients with Sickle Cell Disease in Zaria, Nigeria: A Comparative Study

Abstract

Background: Hydroxyurea (HU), an antimetabolite, was introduced in 1998 in USA as a routine medication for severe SCA, but it is yet to be accepted for routine care in our centre.  

Aims and Objectives: This study determined the knowledge and utilisation of HU among patients with SCA in Zaria. Materials and

Methods: Bio-data, socio-demographic characteristics, Haematological parameters, knowledge and use of HU were assessed using questionnaires in 2006 and 2016 respectively. Data were analysed using SPSS version 20 with level of significance at p ≤ 0.05.

Results: A total of 208 (male 50% vs female 50%) and 119 (male 42% vs female 58%) patients with SCA in 2006 and 2016 respectively were interviewed. The mean ages were 22.0±7.0 vs 23.0±5.0 respectively (p=0.237), Frequency of crises per year was 6.1±2.3 vs 5.6±3.1 (p=0.098), blood units transfused per annum was 3.0 ±1.5 vs 2.3±1.1 (p < 0.0001) in 2006 and 2016 respectively. Four (1.9%) of 208 and 24 (20%) of 119 patients with SCA were aware of HU as a medication while none 0/208 (0%) vs 18/119 (2.6%) were on HU therapy. Barriers to the use of HU were cost of medication 98% vs 82%, non-availability 95% vs 98%, increased follow up visit 98% vs 88% and drug restriction 98% vs 91% in 2006 and 2016 respectively.

Conclusion: Knowledge and utilisation of HU are increasing in Zaria, perceived barriers to its use did not change over the ten year study period. Thus continuous patient education on the advantages of HU therapy in SCA is recommended to increase utilisation.