Clinical Profile, Management Patterns, and Outcomes of Sickle Cell Disease at a Tertiary Hospital in Nigeria

Sickle cell disease (SCD) is a major public health concern in Nigeria, with a high prevalence and significant morbidity and mortality. Despite advances in management strategies, gaps in comprehensive care persist, particularly in resource-limited settings. This study aims to assess the clinical profile, management patterns, and outcomes of SCD patients at a tertiary hospital in Nigeria. A retrospective hospital-based audit was conducted at the University of Medical Sciences Teaching Hospital Complex, Ondo, Nigeria. Medical records of patients diagnosed with SCD were reviewed. Data collected included demographic characteristics, clinical presentations, frequency and types of crises, management strategies, and treatment outcomes. Descriptive and inferential statistical analyses were performed to identify predictors of adverse outcomes. A total of 71 patients were included in the study, with a mean age of 6.8 ± 3.8 years. Vaso-occlusive crises were the most common complication occurring in 74.6% of patients, followed by hemolytic (14.1%), sequestration (4.2%), aplastic (1.4%), and megaloblastic (2.8%) crises. None of the patients received hydroxyurea therapy, while folic acid (97.2%) and antimalarial prophylaxis (95.8%) were the most used medications. The mean number of blood transfusions per year was 1.2 (IQR: 1.0–2.0), and specialist consultations were infrequent. Logistic regression analysis identified lower lowest recorded packed cell volume (PCV) as a significant predictor of adverse outcomes (OR: 0.488, 95% CI: 0.286–0.835, p = 0.009). The findings highlight critical gaps in SCD management, including the underutilization of hydroxyurea and limited access to specialist care. Addressing these gaps through policy initiatives, provider education, and healthcare system strengthening could improve patient outcomes. These results provide valuable insights for optimizing SCD management in Nigeria.