P108: ASSESSMENT OF HEALTHCARE WORKERS’ KNOWLEDGE AND RESOURCE AVAILABILITY FOR CARE OF SICKLE CELL DISEASE AT HEALTH FACILITIES IN DAR ES SALAAM, TANZANIA
Authors: A Jonathan, H Tutuba, W Lloyd, J Ndunguru, J Makani, P Ruggajo, I Minja, E Balandya
Journal: HemaSphere (2022)

Background: Sickle cell disease (SCD) is a global public health priority due to its high morbidity and mortality. In Tanzania, SCD accounts for 7% of under-five mortality. Cost-effective interventions such as early diagnosis and linkage to care have been shown to prevent 70% of deaths but require knowledge among healthcare workers and availability of resources at healthcare facilities. In Tanzania, data on these critical determinants is currently lacking. Aim: To assess healthcare workers’ knowledge and resource availability for care of SCD at Health Facilities in Dar es Salaam, Tanzania. Methods: A facility-based cross-sectional study was conducted between December-2020 and February-2021 among 490 nurses and clinicians at Temeke, Amana, Mwananyamala and Muhimbili National Hospital in Dar es Salaam. Data was collected using structured questionnaire (knowledge) and inventory checklist (resources). Pearson’s Chi-square was used to determine association between level of knowledge and demographic factors. Multivariate logistic regression was used to ascertain the strength of associations. P-values < 0.05 were considered statistically significant. Result: Of the 490 participants (28 years [IQR=26–35]), only 25.1% had good knowledge on SCD. The odds of good knowledge was 82% lower in nurses than clinicians (AOR= 0.177; 95% CI: 0.090, 0.349; p = 0.000); 95% lower in diploma than Master degree holders (AOR = 0.049; 95% CI: 0.008, 0.300; p = 0.001) and 4.6 times higher in those with 5 – 9 years than ≥ 10 years of experience (AOR=4.564; 95%CI: 1.341, 15.525; p=0.015). The regional-level hospitals lacked diagnostic tests and Hydroxyurea. Conclusion: There was a general lack of knowledge on SCD among healthcare workers and limited availability of critical resources for the diagnosis and care of SCD, especially at regional-level hospitals. Efforts are needed for their improvement in order to enhance care to patients, thus reducing the morbidity and mortality due to SCD in Tanzania. References 1. Adegoke et al, Trans R Soc Trop Med Hyg. 2018;112(2):81–7. 2. Ambrose et al, Bull World Health Organ. 2020 Dec 1; 98(12): 859–868. 3. Ansong et al, Mediterr J Hematol Infect Dis. 2013;5(1):1–6. 4. Azonobi et al, BMC Pregnancy Childbirth. 2014;14(1):1–5. 5. Chamba et al, Case Rep Hematol. 2018;2018:1–3. 6. Chide et al, A Cross-sectional Survey. 2020;1–16. 7. Cochran, W. G. 1977. Sampling Techniques, 3rd Ed., New York: John Wiley and Sons, Inc. 8. Diniz et al, Hematol Transfus Cell Ther. 2019;41(2):145–52. 9. Diniz et al, Hematol Transfus Cell Ther. 2019;41(1):62–8. 10. Drive et al, Adv Exp Med Biol. 2017; 1013: 59–87 11. World Health Organisation, Agenda item 11.4. 59th World Health Assembly, 27 May 2006. 2006. 12. Piel et al, PLoS Med. 2013;10(7). 13. Gomes et al, Mediterr J Hematol Infect Dis. 2015;7(1). 14. Gomes et al, BMC Fam Pract. 2011;12. 15. Ministry of Health et al Population Policy Compendium, 1–6. 16. Hyochol et al, Physiol Behav. 2017;176(10):139–48. 17. Jain et al, J Hematol Thromboembolic Dis. 2015;03(06). 18. Jemima et al, Divers Equal Heal Care. 2008;241–54. 19. Makani et al, PLoS One. 2011;6(2). 20. Makani et al, BMC Hematol. 2018;18(1). 21. Mcgann et al, Blood. 2018;129(2):155–62. 22. McWalter et al, Am J Prev Med. 2011;41(6 SUPPL.4):384–9. 23. Ministry of Health and Social Welfare. Minist Heal Soc Welf. 2015;(June):1–16. 24. Mukinayi et al, Trop Med Infect Dis. 2020;5(3):127. 25. Nkya et al, Int Health. 2019; 11(6): 589 – 595. 26. Tanyi et al, J Am Acad Nurse Pract. 2003;15(9):389–97. 27. Tluway et al, British Journal of Haematology. 2017;p. 919–29. 28. Williams et al, BMC Med. 2015;13(1):1–3.