Management of Malaria in Children with Sickle Cell Disease: Knowledge, Attitudes and Practices among Health Care Providers in Kisangani Health Centers, Democratic Republic of the Congo

Objective: This study aimed to assess the knowledge, attitudes, and practices of healthcare providers regarding the impact of sickle cell polymorphism on the prevalence, clinical characteristics, complications, treatment, and prevention of malaria in patients under 5 years of age. Methods: A cross-sectional survey was conducted from March 1, 2024, to June 30, 2024, among 97 volunteer healthcare providers out of approximately 400 medical staff working in 11 health facilities (both private and public) in Kisangani, where a newborn screening program had been implemented. A semi-structured questionnaire with end-closed questions was self-administered under the supervision of trained interviewers. The knowledge level was categorized as low, medium, or high, based on the number of questions answered correctly. Attitudes and practices were rated as satisfactory when respondents answered at least 70% of the related questions correctly. Adequate agreement with the standard principles of clinical interventions indicated satisfactory attitudes and good practices. Results: The 97 respondents comprised 62 males (63.9%) and 35 females (36.1%), aged 30 to 39 years, of whom 36 (37.1%) were physicians (general practitioners and specialists) and 61 (62.9%) nurses. The level of knowledge about the complex relationship between malaria and sickle cell disease (SCD) was low in 23.7%, medium in 56.7%, and high in only 19.5% of participants. Their attitudes and practices were inadequate in 69.1%. However, statistically significant differences were associated with caregiver qualification (ORa = 3.04 [95% CI: 1.57 - 5.88]; P = 0.0009) and the health facilities surveyed (P = 0.0016; ORa = 2.29; 95% CI: 1.37 - 3.85). Conclusion: Awareness raising and capacity building of healthcare providers are needed to enhance malaria management among children with SCD in Kisangani, as current performance is unsatisfactory.