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Socio-environmental exposures and health outcomes among persons with sickle cell disease

View Article: PubMed Central - PubMed

ABSTRACT

There is much variability in the expression of sickle cell disease (SCD) and recent works suggest that environmental and social factors may also influence this variability. This paper aims to use geographic information systems technology to examine the association between socio-environmental exposures and health outcomes in all persons who have attended or currently attend the Sickle Cell Unit in Jamaica. Rural patients presented for clinical care at older ages and had less annual visits to clinic. Persons travelled relatively long distances to seek SCD care and those travelling longer had less health maintenance visits. Urban patients had a higher prevalence of significant pain crises (69.4% vs. 55.8%, p value<0.001) and respiratory events (21.2% vs. 14%, p value<0.001). Prevalence of leg ulcers did not vary between rural and urban patients but was higher in males than in females. Females also had lower odds of having respiratory events but there was no sex difference in history of painful crises. Persons with more severe genotypes lived in higher poverty and travelled longer for healthcare services. Persons in areas with higher annual rainfall, higher mean temperatures and living farther from factories had less painful crises and respiratory events. The paper highlights a need for better access to healthcare services for Jamaicans with SCD especially in rural areas of the island. It also reports interesting associations between environmental climatic exposures and health outcomes.

No MeSH data available.


Distance from a sickle cell clinic in kilometres.
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pone.0175260.g001: Distance from a sickle cell clinic in kilometres.

Mentions: The mean ratio of SCD patients to general population by communities was 0.5% ± 0.3% and ranged between 0.02% and 4.8%. The mean poverty index was 12.0% ± 13.3%. Patients travelled a mean distance of 20.9±16.8 kilometers to access SCU services (Fig 1). The total number of visits made to the SCU by patients ranged between 1 to 1,096 visits (mean total visits: 40.0±53.0 visits) over a time span of 6 months to 60 years (mean time attending SCU: 12.9±11.2 years).


Socio-environmental exposures and health outcomes among persons with sickle cell disease
Distance from a sickle cell clinic in kilometres.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC5383275&req=5

pone.0175260.g001: Distance from a sickle cell clinic in kilometres.
Mentions: The mean ratio of SCD patients to general population by communities was 0.5% ± 0.3% and ranged between 0.02% and 4.8%. The mean poverty index was 12.0% ± 13.3%. Patients travelled a mean distance of 20.9±16.8 kilometers to access SCU services (Fig 1). The total number of visits made to the SCU by patients ranged between 1 to 1,096 visits (mean total visits: 40.0±53.0 visits) over a time span of 6 months to 60 years (mean time attending SCU: 12.9±11.2 years).

View Article: PubMed Central - PubMed

ABSTRACT

There is much variability in the expression of sickle cell disease (SCD) and recent works suggest that environmental and social factors may also influence this variability. This paper aims to use geographic information systems technology to examine the association between socio-environmental exposures and health outcomes in all persons who have attended or currently attend the Sickle Cell Unit in Jamaica. Rural patients presented for clinical care at older ages and had less annual visits to clinic. Persons travelled relatively long distances to seek SCD care and those travelling longer had less health maintenance visits. Urban patients had a higher prevalence of significant pain crises (69.4% vs. 55.8%, p value<0.001) and respiratory events (21.2% vs. 14%, p value<0.001). Prevalence of leg ulcers did not vary between rural and urban patients but was higher in males than in females. Females also had lower odds of having respiratory events but there was no sex difference in history of painful crises. Persons with more severe genotypes lived in higher poverty and travelled longer for healthcare services. Persons in areas with higher annual rainfall, higher mean temperatures and living farther from factories had less painful crises and respiratory events. The paper highlights a need for better access to healthcare services for Jamaicans with SCD especially in rural areas of the island. It also reports interesting associations between environmental climatic exposures and health outcomes.

No MeSH data available.