Study location and population
Abeokuta South is a Local Government Area in Ogun State, Nigeria. It was established in 1991 and mainly inhabited by the Egbas, who are of Egba Eku, Egba Aarin and Egba Igbeyin. The headquarter of the LGA is at Abeokuta7°09′00″N 3°21′00″E. It has an area of 71 km2 and a population of 250,278 at the 2006 census. The Local Government shares border with Odede LGA on its North frontier, Obafemi/Owode on the Eastern while Abeokuta North LGA on the Southern part respectively. The Local Government is divided into 15wards for the purpose of electing councilors into the Local Government Council. Each electoral ward has primary health centre, private clinics, laboratories, pharmacy shops, and traditional birth attendants.
Study design
This study is a descriptive cross-sectional study to describe systematically the prevention practices influencing the frequency of occurrence of vaso-occlusive crisis among patients Abeokuta south Local Government Area of Ogun State, Nigeria.
Setting
This study was conducted in State Hospital Sokenu, Abeokuta and Egba Medical Centre, Isabo, Abeokuta both in Abeokuta South Local Government Area. The two hospitals are the two major sickle cell treatment centre in Abeokuta South LGA, Ogun State.
Sampling technique
A consecutive non randomized sampling of all the sickle cell patients that attend the selected facilities was used to recruit participants into the study.
Sample size determination
The minimum number of subjects required for the study is calculated using the formula :
Minimum sample size, n = Z2 p q/d2
Where Z is the standard deviation set at 1.96 at 95% confidence interval, p = prevalence set at 50%, q = 1-p, and d = degree of accuracy set at 0.05
$$ \begin{array}{l} n = Z2\ \mathrm{pq}/\mathrm{d}2\\ {}\frac{=1.96\ 2\ \mathrm{x}0.5\mathrm{x}0.5}{0.05^2 = 384.}\end{array} $$
n was calculated to be 384.
A total of 415 participants were recruited.
Data collection method
Data were collected with the use of interviewer administered pre-validated questionnaire. The interviewers were volunteer Doctors, Nurses and Laboratory Scientists. The interviewers were previously briefed on the nature and significance of the study and they were trained on how to administer the questionnaire under supervision. On the clinic days of each selected health facility, the researchers meet the participants, re- explained the purpose of the study and assured them of confidentiality of privileged information and a feedback after the study as told to them in the last meeting. The study was conducted between January and April 2015.
Ethical approval
Ethical approval to conduct the study was obtained from the ethical committee of the Olabisi Onabanjo University Teaching Hospital, Sagamu. Permission was also obtained from the selected health facilities for the study, discussed with the Officers in-charge on the aims and objectives of the study, the procedure and feedback was assured which could contribute to the management of their patients. At the end of each meeting with the hospital management, verbal consent was obtained.
Written consent was obtained from the study participants before the commencement of the study. The participants were met on the day of clinics by the researchers and the purpose, general content and nature of the study were explained and they were given assurance of confidentiality of information offered and feedback at the end of the study.
For participants under the age of 16, written parental consent was obtained. All the patients have their parents or guardians present in the clinic with them to care for them.
Data analysis
Statistical analyses were conducted using SPSS for Windows version 20.0 First, descriptive statistics were generated for each survey measure. Quantitative data collected was checked for errors, cleaned and entered. Data was summarized with proportions and means and presented using frequency tables. Frequency of crisis was categorized as either Once or less monthly (low frequency) and twice or more monthly as high frequency of crisis.
Variables such as plenty fluid was elicited by asking how many glass of cup of water do you take daily- showing them a 500mls cup. Three litres [6 glass of cup daily] was classified as adequate. Balance diet was taken as the description of diet containing carbohydrate, protein and fats for three previous meals. A strenuous activity was described as patient’s involvement in additional non routine, high oxygen demanding activities.
Bivariate analyses using the X
2 test were used to compare the socio-demographics of participants with the frequency of sickle cell crisis status of their child. The level of statistical significance was set at 5%. A logistic regression model was produced with low and high frequency of crisis as outcome variable. All explanatory variables that were associated with the outcome variable in bivariate analyses, variables with a P-value of ≤0.05 were included in the logistic models.