Improving Sickle Cell Disease Care in Nigeria by Increasing Use of Hydroxyurea Using Task-Strengthening Strategies and Provider Training

What this Trial Is About

This research aims to improve the use of hydroxyurea HU for managing sickle cell disease SCD in Nigeria, where most patients currently do not receive evidence-based care despite HUs potential to reduce complications and mortality. The study addresses provider barriers to HU adoption using a practical approach based on previous NIH-funded trials and Nigerian health guidelines. It focuses on increasing HU adoption by healthcare providers through a tailored strategy in clinical settings. The study compares two approaches at 20 clinical sites one group receives educational information about task sharing SIM, and the other group receives an enhanced strategy called TASSH TCP, which includes healthcare worker training, clinical reminders, and practice facilitation to support SCD management. The study follows a cluster randomized design to assess which approach leads to better adoption of HU treatment over 12 months. The implementation and sustainability of these methods are also evaluated at 12 and 24 months. Participants include SCD patients registered at local clinical sites, with assessments including screening, HU treatment initiation, and dosage monitoring at 12 months. Data on adoption rates, implementation fidelity, and mediators affecting these outcomes are collected. The study will help identify scalable and sustainable ways to improve HU use in Nigeria and monitor patient outcomes through electronic medical records over the study period, which runs until May 2028.

mAnaging siCkle CELl disEase Through incReased AdopTion of hydroxyurEa in Nigeria