Knowledge, Attitude and Practices towards sickle cell screening among Health workers in Tororo District-Uganda, 2018

  • Public health surveillance
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Background:
Tororo has a high prevalence (19.6%) of sickle cell trait compared to the national prevalence of 13.3%. In 2016, the Ministry of Health, Uganda rolled out a Sickle Cell Screening Programme (SCSP) for the new born children among health workers (HW) in Tororo district. Training focused on screening, diagnosis and management of sickle cell disease. We assessed HW’s knowledge, attitude and practices towards SC screening 2 years following the roll out of the SCSP.
Methods:
A cross sectional survey was conducted in June, 2018 among 180 HWs randomly selected from all (38) public health facilities. Knowledge was determined using 10 items from Uganda national sickle cell guidelines and data consid- ered good for scores above 6 and poor for scores below 6. Attitude of HWs and practice on SC screening was explored through interviews conducted with 10 key informants and 10 in-depth interviewees. Sickle cell screening practice was based on 4 practice questions. Factors associated with good knowledge and practice were determined using prevalence ratios (PR) with corresponding 95% confidence intervals (CI) using a generalised linear model with the family of Poisson and a log link and robust standard error were obtained. Qualitative data were analysed using manual thematic analysis.
Results:
Nearly two-thirds 116 (64.4%) of HWs were female and rural residents 113 (64.9%). Overall, knowledge about SC screening was low 125 (69.4%). Health workers cared and supported clients to screen for sickle cell, considered screening fully as their responsibility, and believed that screening prevented transmission of sickle cell genes to others. Only 62.2% reported screening clients for SC. Fifty one percent made client referrals, 36.5% did premarital counselling and 12.2% conducted SC awareness campaigns. Urban-residence (aPR=1.11, 95% CI; 1.03-1.19), higher income level (aPR= 1.30, 95% CI; 1.13-1.47) and prior training in SC screening (aPR= 1.09, 95% CI; 1.01-1.20) were key determinants of good knowledge.
Conclusion
Over all, knowledge and practice of SC screening is low. Attitude of HWs towards SC screening was positive. The District Health Office should carry out regular refresher training of HWs to improve HWs knowledge and practice of SC screening.

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