Positive depression screening and associated factors among children with sickle cell anemia attending a tertiary hospital in Mwanza, Tanzania: A Cross-sectional study

• Children with Sickle cell anemia (SCA) are particularly vulnerable to depression. • Depression among SCA often goes undiagnosed and untreated. • In this study one in five children with SCA demonstrated depressive symptoms. • Middle adolescence and those with severe SCA disease were associated with higher odds of depressive symptoms. • Regular mental health assessments should be integrated into the routine care of children with SCA. Depression is an increasingly important public health concern among children, particularly those living with chronic illnesses, including sickle cell anemia. Due to a lack of routine screening in sickle cell clinics, depression often goes undiagnosed and untreated, making it crucial to assess its magnitude for appropriate intervention. Therefore, this study aimed to determine the prevalence and factors associated with positive depression screening among children with sickle cell anemia attending Bugando Medical Centre, a tertiary hospital in Mwanza, northwestern Tanzania. A hospital-based cross-sectional study was conducted among children with sickle cell anemia attending the pediatric and medical outpatient clinics at Bugando Medical Centre. Structured questionnaires were used to collect data on sociodemographic and disease severity while likelihood of depression was determined using the Children's Depression Inventory tool. Participants were recruited using a systematic sampling technique between January 1st and March 31st 2024. A total of 200 participants were enrolled, with a median age of 11 [IQR 9–13] years and more than half of the participants were male, 104 (52.0 %). Elevated risk of depression was identified in 20 % of the children. Children in middle adolescence (AOR:3.1, 95 % CI:1.1–8.2, p = 0.036) and those with severe sickle cell anemia (AOR:5.0, 95 % CI:1.5–19.6, p = 0.010) had higher odds of positive depression screening. One in five children with sickle cell anemia demonstrated symptoms of depression, highlighting a significant mental health burden and underscoring the urgent need for targeted mental health interventions, especially among sickle cell anemia patients in middle adolescence and those with severe sickle cell anemia.