Kilonzi Manase, Mlyuka Hamu J, Felician Fatuma Felix, Mwakawanga Dorkasi L, Chirande Lulu, Myemba David T, Sambayi Godfrey, Mutagonda Ritah F, Mikomangwa Wigilya P, Ndunguru Joyce, Jonathan Agnes, Ruggajo Paschal, Minja Irene Kida, Balandya Emmanuel, Makani Julie, Sirili Nathanael
School of Pharmacy, The Muhimbili University of Health and Allied Sciences, Dar es Salaam P.O. Box 65013, Tanzania.
School of Nursing, The Muhimbili University of Health and Allied Sciences, Dar es Salaam P.O. Box 65013, Tanzania.
Hemato. 2021 Dec;2(4):713-726. doi: 10.3390/hemato2040048. Epub 2021 Nov 28.
Factors contributing to low use of HU among SCD patients exist in high-income countries. The latter leaves a drift of literature on factors for low utilization of HU in developing countries. This study aimed to explore the factors influencing the use of HU in the management of SCD in Tanzania. A qualitative study was employed to interview purposively selected participants for this study. The in-depth interviews were conducted with 11 parents of children with SCD, four medical doctors working at sickle cell clinics, and two representatives of the national health insurance fund (NHIF). Interviews were audio-recorded, transcribed, and thematically analysed. Barriers identified were misconception of parents on SCD, financial constraints, regulatory restrictions, worries and fears of medical doctors on the acceptability of HU, shortages of laboratory equipment and consumables, and limited availability of HU. Adequate knowledge of the parents and medical doctors on SCD and HU and opportunities for HU accessibility were the facilitators identified. The utilization of HU by the individual with SCD is affected by several factors, from individual to policy level. Nevertheless, parents of children with SCD and medical doctors working in sickle cell clinics demonstrated good knowledge of the diseases and HU.
在高收入国家存在导致镰状细胞病（SCD）患者羟基脲（HU）使用率低的因素。这使得关于发展中国家HU低利用率因素的文献出现空白。本研究旨在探讨影响坦桑尼亚SCD治疗中HU使用的因素。采用定性研究方法，有目的地选取本研究的参与者进行访谈。对11名SCD患儿的家长、4名在镰状细胞病诊所工作的医生以及国家健康保险基金（NHIF）的两名代表进行了深入访谈。访谈进行了录音、转录并进行了主题分析。确定的障碍包括家长对SCD的误解、经济限制、监管限制、医生对HU可接受性的担忧和恐惧、实验室设备和耗材短缺以及HU供应有限。确定的促进因素包括家长和医生对SCD和HU的充分了解以及HU可及的机会。SCD患者对HU的使用受到从个体到政策层面的几个因素的影响。然而，SCD患儿的家长和在镰状细胞病诊所工作的医生对该疾病和HU表现出了良好的了解。
