Determinants of immunisation in children with sickle cell disease in Libreville

Background: Infectious diseases are frequent and sometimes deadly in sickle cell disease (SCD) patients. Some of these infectious diseases could be avoided through immunisation, but an immunisation schedule for children with SCD is not available in Gabon. Aim: This study looked into the determinants of immunisation in children with SCD in Libreville. Setting: This work was performed in five healthcare facilities in Libreville. Methods: A cross-sectional study on knowledge, attitudes, and practices was conducted from February 2019 to September 2019 in Libreville healthcare facilities, targeting children under 18 years with SCD. Results: A total of 172 parents of children with SCD participated. The average age of children was 7.1 ± 4.2 years, with a sex ratio of 1:36. Immunisation status was considered complete for 87.9% (95% CI = 79.8–93.1) according to the Expanded Programme of Immunisation (EPI) schedule. Only 49 (28.5%) parents understood SCD complications, and 39 (22.7%) knew how to prevent them. Immunisation coverage was better for children near public health centres (p = 0.008). For non-EPI vaccines, coverage improved for children of married parents (p = 0.041) and those seen by paediatricians in private facilities (p = 0.046). Multivariate analysis indicated that marital status, a lack of knowledge, facility access, and high vaccine costs predicted immunisation coverage. Conclusion: Immunisation coverage of children with SCD was better than the national immunisation coverage in Gabon. Contribution: This study unravels the need for Gabon to improve its immunisation programmes in public healthcare facilities.