Description
Background: Sickle cell disease (SCD) is a genetic blood disorder associated with high childhood mortality, especially in resource-limited settings where access to early diagnosis and quality comprehensive care is limited. In western Kenya, about 4.5% of children are born with SCD. PEN-Plus care model focuses on equipping middle level healthcare providers with expertise on diagnosis and care for chronic PEN-PLUS conditions e.g SCD through mentorship and referrals while providing all essential medicines for their care. It was established at Hamisi Clinic to address some of these gaps.
Objective: To evaluate the impact of the PEN-PLUS comprehensive care model on vaso-occlusive crisis (VOC) occurrence and clinic attendance.
Methodology: A retrospective analysis was conducted using clinical data from patients’ files, daily register, monthly summary forms that captured clients visiting the clinic with VOCs comparing two periods; June–December 2023(baseline) and June–December 2024(post-intervention). The interventions included accurate hydroxyurea titration, early diagnosis and treatment of acute complications, screening of other family members, health education on drug adherence and hydration, stigma reduction, clinic follow up and community engagements for referrals.
Results: From June–December 2023, 183 SCD clinic visits were recorded, 67(36.6%) reported VOCs. In the same period of 2024, 682 SCD clinic revisits were recorded, 88(12.9%) reported VOCs. This reflects 64.8% reduction in VOC incidence and 272% increase in clinic utilization. Following monthly community engagement and a mobilized pediatric population SCD screening of 300 children, 33(11%) were HbAS genotype, 4(1.33%) were HBSS genotype and were initiated on care.
Conclusion/Recommendation: Above interventions improved patient outcomes by significantly reducing VOCs and increasing service utilization. These results support scaling integrated SCD services within primary care settings in similar resource-limited contexts.
Keywords: SCD, HbAS, HbSS primary care setting, comprehensive care
| Country | Kenya |
|---|---|
| Organization | Non-Governmental Organization (NGO) |
| Position | NURSING OFFICER |
| Received a Grant? | No |
| If yes, give grant details | N/A |
