Outcome of holistic care in Nigerian patients with sickle cell anaemia.

Holistic care of patients with sickle cell anaemia (HbSS) was carried out in a dedicated support group and clinic in Lagos. This paper examines the outcome of this initiative using mortality, hospital admission and blood transfusion rates from inception in April 1988 to December 1995. Patients with sickle cell disorder and their families were admitted to the Sickle Cell Club and its associated Sickle Cell Clinic. All patients and parents were counselled on recruitment and were regularly followed up within an interactive family friendly environment. Other measures included preventive health and nutritional education, prompt treatment of illness and free supplies of vitamin supplements, malarial prophylactic and other necessary medication. The records of consecutive patients with HbSS were reviewed for this study. Over the study period, the number of subjects increased from 290 in 1988 to 1223 in 1995. The mortality rate fell from 20.6% in 1988 to 0.6% in 1995 (P < 0.0001); the number of hospital admissions fell from 350 (119%) in 1988 to 30 (4%) in 1995 (P < 0.0001); the number of patients transfused with blood fell from 260 (90%) in 1988 to 25 (2%) in 1995 (P < 0.00001). We conclude that the provision of well-organized holistic care can significantly reduce illness and deaths and improve the quality of lives of people living with HbSS in developing countries.