Assessment of healthcare workers' knowledge and availability of resources for sickle cell disease management in Bukavu, Democratic Republic of the Congo.

Introduction: Sickle cell disease (SCD) is a global public health priority due to its high morbidity and mortality. In the Democratic Republic of the Congo (DRC), effective care for this disease depends on the availability of resources and the level of knowledge of healthcare workers (HCWs). However, in Bukavu, there is limited data available on these two crucial aspects, which are vital for enhancing the care of patients with SCD. This study aims to assess the availability of SCD services and the level of knowledge of HCWs in Bukavu, DRC.

Methods: A cross-sectional study based on healthcare facilities (HCFs) was carried out between March and May 2024 among 501 nurses and clinicians from 58 HCFs in Bukavu. Data were collected using a structured questionnaire with 13 knowledge questions (score >7 corresponding to good knowledge) and a checklist of available resources. Pearson's χ2 test was used to assess the association between knowledge level and participant characteristics. Multivariate logistic regression was performed to determine the factors influencing knowledge.

Results: Of the 501 participants, only 16.4% demonstrated good knowledge of SCD. Physicians were 8.4 times more likely to possess good knowledge compared to nurses (adjusted OR = 8.4; 95% CI: 4.5 - 15.9; p<0.0001). Age, clinical experience, type of HCF, attendance of SCD training, and previous management of SCD patients did not show a significant association with knowledge after adjusting for other variables (p>0.05). Regarding resources, 55.2% of HCFs had a falciform test, but none had advanced technologies such as isoelectrofocusing or high-performance liquid chromatography.

Conclusion: This study reveals a general lack of knowledge among HCWs about SCD in Bukavu, as well as limited availability of resources for diagnosis and treatment. It is essential to improve the training of HCWs and to strengthen HCFs in order to optimize the management of SCD patients in Bukavu.