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Caregiver Knowledge, Adherence, and Barriers to Hydroxyurea Therapy Among Children with Sickle Cell Disease at the University of Benin Teaching Hospital, Benin City, Nigeria
Category: Original Articles
Published: October 2026
Issue: Vol. 4, Issue 2
Pages: 246 - 257
Authors
Lilian Ezeuko
Department of Child Health, University of Benin Teaching Hospital, Benin City, Edo state, Nigeria
lilian.ezeuko@npmcn.edu.ng
Magdalene Odunvbun
Department of Child Health, University of Benin Teaching Hospital, Benin City, Edo state, Nigeria
Vitalis Chukwuma Ezeuko
Department of Child Health, University of Benin Teaching Hospital, Benin City, Edo state, Nigeria
Abstract

Background: Hydroxyurea (HU) therapy is an evidence-based treatment for sickle cell disease (SCD) that reduces the frequency of vaso-occlusive crises and improves haematological outcomes. Despite its proven benefits, adherence remains suboptimal, and caregiver knowledge influences treatment success. Limited data exist on caregiver awareness, adherence, and barriers to HU therapy in Nigerian children with SCD.
Objective: To assess caregiver knowledge, level of adherence, and reported barriers to hydroxyurea therapy among children with sickle cell disease at the University of Benin Teaching Hospital, Benin City, Nigeria.
Methods: This hospital-based cross-sectional study was conducted at the University of Benin Teaching Hospital, Benin City, Nigeria. One hundred children with sickle cell disease receiving hydroxyurea therapy and their caregivers were enrolled. Data on caregiver knowledge, level of adherence and self-reported barriers to HU therapy among children with SCD were collected using a structured interviewer-administered questionnaire. Good adherence was defined as missing ≤1 dose in the preceding 7 days and ≤4 doses in the preceding one month. Data were analysed using SPSS version 26.0. Statistical significance was set at p < 0.05.
Results: The mean age of children was 10.35 ± 4.34 years, with 54% males. All caregivers (100%) had heard of hydroxyurea therapy, but only 56% knew its purpose, and over half (52%) rated their knowledge as poor. Good adherence was observed in 58% of children. Commonly reported barriers included inconsistent availability of hydroxyurea (72%) and missed doses due to running out of medication. Most caregivers (82%) reported significant improvement in their children, and 95% expressed satisfaction with therapy.
Conclusion: Awareness of HU is high among caregivers, but knowledge gaps and medication access barriers limit optimal adherence. Strengthening caregiver education and ensuring consistent HU availability are essential to improve treatment outcomes in children with SCD.

Keywords:
Adherence, Caregiver knowledge, Hydroxyurea, Sickle cell disease
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How to Cite This Article
Lilian Ezeuko, Magdalene Odunvbun, Vitalis Chukwuma Ezeuko. (October 2026). Caregiver Knowledge, Adherence, and Barriers to Hydroxyurea Therapy Among Children with Sickle Cell Disease at the University of Benin Teaching Hospital, Benin City, Nigeria. Eastern Heartland Journal of Medicine, Volume 4, Issue 2, pp. 246-257.
Article Information

Submitted: March 20, 2026

Published: October 17, 2026

Pages: 246 - 257

Journal: Eastern Heartland Journal of Medicine

Publisher: Federal Teaching Hospital Owerri, Nigeria

ISSN: 2734-2875 (Print)