{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T13:08:16Z","timestamp":1773925696095,"version":"3.50.1"},"reference-count":28,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T00:00:00Z","timestamp":1773878400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"National Heart, Lung, and Blood Institute (NHLBI) of the US National Institutes of Health","award":["U01 HL156853"],"award-info":[{"award-number":["U01 HL156853"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objective: The most common hemoglobin disorder in the world is SCD. The majority of SCD cases come from Africa, accounting for up to two-thirds of the 300,000 annual births of individuals with SCD worldwide. In Tanzania, 11,000\u201314,000 babies are born with SCD each year. Despite treatment advancement, pain is still an attributable cause of admissions among patients with SCD. However, data are still lacking regarding the adequacy of pain control in patients with SCD in Tanzania. The aim of this study was to determine factors affecting pain control among patients with SCD presenting with painful events at Mwananyamala Regional Referral Hospital (MRRH) and Muhimbili National Hospital (MNH) in Dar es Salaam, Tanzania. Methods: This was a cross-sectional study conducted at MRRH and MNH, which are tertiary referral hospitals in Dar es Salaam, Tanzania. Patients with SCD aged 8 years and above who presented at the hospitals with painful events (from August 2022 to February 2023) were enrolled in the study. We used a structured questionnaire to collect data on participants\u2019 socio-demographic characteristics and clinical parameters. The adequacy of pain control was assessed using the WHO Pain Management Index. Multivariable binary logistic regression was used to determine factors associated with pain control. Differences were considered statistically significant when the p-value was &lt;0.05. Results: A total of 390 patients with SCD were analyzed. The mean age (\u00b1SD) was 15 (\u00b16) years. Most patients were recruited from outpatient clinics (88.2%). The male-to-female ratio was 1:1. The majority of patients had less than three pain episodes per year (77.9%), and about 64.6% presented to the hospital with mild pain. The proportion of patients on hydroxyurea was 62.3%. Furthermore, one-third of patients had inadequate pain control. Factors associated with inadequate pain control included receiving initial pain management in other health facilities (adjusted odds ratio [aOR] and 95% confidence interval [CI] = 2.5 (1.5\u20134.5), p = 0.001), presenting to the hospital with moderate pain (aOR = 2.2, 95% CI [1.3\u20133.8], p = 0.0060), and presenting to the hospital with a fever (aOR = 3.8, 95% CI [1.1\u201313.9], p = 0.04). Having severe pain and receiving initial treatment at MRRH and MNH seemed to be protective factors (aOR = 0.33, 95% CI [0.11\u20130.97], p = 0.04, and aOR = 0.29, 95% CI [0.14\u20130.61], p = 0.001, respectively). Conclusions: A considerable proportion of patients with SCD receive suboptimal pain control. Receiving initial pain management from another healthcare facility, presenting to the hospital with moderate pain, and having a fever were associated with inadequate pain control. Further research is warranted to elucidate ways of optimizing the management of pain in patients with SCD in Tanzania.<\/jats:p>","DOI":"10.3390\/jcm15062339","type":"journal-article","created":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T08:54:37Z","timestamp":1773910477000},"page":"2339","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Factors Affecting Pain Control in Patients with Sickle Cell Disease at Mwananyamala and Muhimbili Hospitals in Dar es Salaam, Tanzania"],"prefix":"10.3390","volume":"15","author":[{"given":"Happiness Joseph","family":"Igogo","sequence":"first","affiliation":[{"name":"Department of Haematology and Blood Transfusion, Muhimbili University of Health and Allied Sciences, Dar es Salaam P.O. Box 65001, Tanzania"},{"name":"Sickle Pan-African Research Consortium (SPARCO), Dar es Salaam P.O. Box 65001, Tanzania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0764-0196","authenticated-orcid":false,"given":"Mbonea","family":"Yonazi","sequence":"additional","affiliation":[{"name":"Sickle Pan-African Research Consortium (SPARCO), Dar es Salaam P.O. Box 65001, Tanzania"},{"name":"Muhimbili National Hospital, Dar es Salaam P.O. Box 65000, Tanzania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8963-4920","authenticated-orcid":false,"given":"Ritah F.","family":"Mutagonda","sequence":"additional","affiliation":[{"name":"Sickle Pan-African Research Consortium (SPARCO), Dar es Salaam P.O. Box 65001, Tanzania"},{"name":"Department of Clinical Pharmacy and Pharmacology, Muhimbili University of Health and Allied Sciences, Dar es Salaam P.O. Box 65013, Tanzania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Avelina","family":"Mgasa","sequence":"additional","affiliation":[{"name":"National Blood Transfusion Services, Dar es Salaam P.O. Box 65019, Tanzania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mwashungi","family":"Ally","sequence":"additional","affiliation":[{"name":"Department of Haematology and Blood Transfusion, Muhimbili University of Health and Allied Sciences, Dar es Salaam P.O. Box 65001, Tanzania"},{"name":"Sickle Pan-African Research Consortium (SPARCO), Dar es Salaam P.O. Box 65001, Tanzania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5154-7872","authenticated-orcid":false,"given":"Clara","family":"Chamba","sequence":"additional","affiliation":[{"name":"Department of Haematology and Blood Transfusion, Muhimbili University of Health and Allied Sciences, Dar es Salaam P.O. Box 65001, Tanzania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1513-0484","authenticated-orcid":false,"given":"Ahlam","family":"Nasser","sequence":"additional","affiliation":[{"name":"Department of Haematology and Blood Transfusion, Muhimbili University of Health and Allied Sciences, Dar es Salaam P.O. Box 65001, Tanzania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"William","family":"Mawalla","sequence":"additional","affiliation":[{"name":"Department of Haematology and Blood Transfusion, Muhimbili University of Health and Allied Sciences, Dar es Salaam P.O. Box 65001, Tanzania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9179-0957","authenticated-orcid":false,"given":"Magdalena A.","family":"Lyimo","sequence":"additional","affiliation":[{"name":"Department of Haematology and Blood Transfusion, Muhimbili University of Health and Allied Sciences, Dar es Salaam P.O. Box 65001, Tanzania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Benson","family":"Kidenya","sequence":"additional","affiliation":[{"name":"Sickle Pan-African Research Consortium (SPARCO), Dar es Salaam P.O. Box 65001, Tanzania"},{"name":"Department of Biochemistry and Molecular Biology, Catholic University of Health and Allied Sciences, Mwanza P.O. Box 1464, Tanzania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Agness","family":"Jonathan","sequence":"additional","affiliation":[{"name":"Sickle Pan-African Research Consortium (SPARCO), Dar es Salaam P.O. Box 65001, Tanzania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Florence","family":"Urio","sequence":"additional","affiliation":[{"name":"Sickle Pan-African Research Consortium (SPARCO), Dar es Salaam P.O. Box 65001, Tanzania"},{"name":"Department of Biochemistry and Molecular Biology, Muhimbili University of Health and Allied Sciences, Dar es Salaam P.O. Box 65001, Tanzania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paschal","family":"Rugajjo","sequence":"additional","affiliation":[{"name":"Sickle Pan-African Research Consortium (SPARCO), Dar es Salaam P.O. Box 65001, Tanzania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3707-9985","authenticated-orcid":false,"given":"Emmanuel","family":"Balandya","sequence":"additional","affiliation":[{"name":"Sickle Pan-African Research Consortium (SPARCO), Dar es Salaam P.O. Box 65001, Tanzania"},{"name":"Department of Physiology, Muhimbili University of Health and Allied Sciences, Dar es Salaam P.O. Box 65001, Tanzania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lulu","family":"Chirande","sequence":"additional","affiliation":[{"name":"Sickle Pan-African Research Consortium (SPARCO), Dar es Salaam P.O. Box 65001, Tanzania"},{"name":"Department of Pediatric and Child Health, Muhimbili University of Health and Allied Sciences, Dar es Salaam P.O. Box 65001, Tanzania"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,3,19]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2018","DOI":"10.1016\/S0140-6736(10)61029-X","article-title":"Sickle-cell disease","volume":"376","author":"Rees","year":"2010","journal-title":"Lancet"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1186\/s43088-023-00373-w","article-title":"Recent progress in the treatment of sickle cell disease: An up-to-date review","volume":"12","author":"Acharya","year":"2023","journal-title":"Beni-Suef Univ. J. Basic Appl. Sci."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1077","DOI":"10.1016\/j.jpain.2015.07.005","article-title":"Frequency of Hospitalisations for Pain and Association with Altered Brain Network Connectivity in Sickle Cell Disease","volume":"16","author":"Darbari","year":"2015","journal-title":"J. Pain"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1128","DOI":"10.1197\/S1069-6563(03)00372-5","article-title":"Clinically important change in the visual analog scale after adequate pain control","volume":"10","author":"Lee","year":"2003","journal-title":"Acad. Emerg. Med."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"725","DOI":"10.1016\/S0140-6736(97)07330-3","article-title":"Sickle-cell disease","volume":"350","author":"Serjeant","year":"1997","journal-title":"Lancet"},{"key":"ref_6","unstructured":"Abala, C. (2018). Acute Pain Management and Control Among Children with Sickle Cell Anemia Attending the Sickle Cell Clinic-Mulago Hospital. [Master\u2019s Thesis, Makerere University]."},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Makani, J., Tluway, F., Makubi, A., Soka, D., Nkya, S., Sangeda, R., Mgaya, J., Rwezaula, S., Kirkham, F.J., and Kindole, C. (2018). A ten year review of the sickle cell program in Muhimbili National Hospital, Tanzania. BMC Hematol., 18.","DOI":"10.1186\/s12878-018-0125-0"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"925","DOI":"10.1007\/s00277-020-03977-9","article-title":"Pathophysiology and recent therapeutic insights of sickle cell disease","volume":"99","author":"Shah","year":"2020","journal-title":"Ann. Hematol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"114","DOI":"10.1016\/S0885-3924(01)00407-9","article-title":"Assessment of sickle cell pain in children and young adults using the adolescent pediatric pain tool","volume":"23","author":"Franck","year":"2002","journal-title":"J. Pain Symptom Manag."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1097\/AJP.0000000000000889","article-title":"Pain in Youth with Sickle Cell Disease: A Report from the Sickle Cell Clinical Research and Intervention Program","volume":"37","author":"Alberts","year":"2021","journal-title":"Clin. J. Pain"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"97","DOI":"10.2190\/7XMD-L45D-47DH-7MEC","article-title":"Drug addiction in sickle cell disease: Case report","volume":"33","author":"Alao","year":"2003","journal-title":"Int. J. Psychiatry Med."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"642","DOI":"10.1002\/pbc.22069","article-title":"Health Care Utilization and Expenditures for Privately and Publicly Insured Children with Sickle Cell Disease in the United States","volume":"53","author":"Mvundura","year":"2009","journal-title":"Pediatr. Blood Cancer"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1076","DOI":"10.1097\/AJP.0000000000000361","article-title":"Multiple Levels of Suffering Discrimination in Health-Care Settings is Associated with Enhanced Laboratory Pain Sensitivity in Sickle Cell Disease","volume":"32","author":"Mathur","year":"2016","journal-title":"Clin. J. Pain"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"158","DOI":"10.12968\/bjon.2009.18.3.39043","article-title":"Barriers to effective pain management in sickle cell disease","volume":"18","author":"Wright","year":"2009","journal-title":"Br. J. Nurs."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"187","DOI":"10.3233\/CH-189007","article-title":"Sickle cell dehydration: Pathophysiology and therapeutic applications","volume":"68","author":"Brugnara","year":"2018","journal-title":"Clin. Hemorheol. Microcirc."},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Shahid, A., Wilkinson, K., Marcu, S., and Shapiro, C.M. (2011). Brief Pain Inventory (BPI). STOP, THAT and One Hundred Other Sleep Scales, Springer.","DOI":"10.1007\/978-1-4419-9893-4_13"},{"key":"ref_17","unstructured":"Cleeland, C.S. (2025, November 09). The Brief Pain Inventory User Guide. Available online: https:\/\/www.mdanderson.org."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1388","DOI":"10.1002\/pbc.24539","article-title":"A Novel WT1 Mutation in Familial Wilms Tumor","volume":"60","author":"Melchionda","year":"2013","journal-title":"Pediatr. Blood Cancer"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"2656","DOI":"10.1182\/bloodadvances.2020001851","article-title":"American Society of Hematology 2020 guidelines for sickle cell disease: Management of acute and chronic pain","volume":"4","author":"Brandow","year":"2020","journal-title":"Blood Adv."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"189","DOI":"10.24248\/eahrj.v6i2.699","article-title":"Lived Experiences of Adults with Sickle Cell Disease: A Qualitative Study, Dar es Salaam, Tanzania","volume":"6","author":"Mkoka","year":"2022","journal-title":"East Afr. Health Res. J."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"300","DOI":"10.1097\/00005792-199611000-00002","article-title":"Hydroxyurea and Sickle Cell Anemia. Clinical utility of a myelosuppressive \u201cswitching\u201d agent. The Multicenter Study of Hydroxyurea in Sickle Cell Anemia","volume":"75","author":"Charache","year":"1996","journal-title":"Medicine"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"a015032","DOI":"10.1101\/cshperspect.a015032","article-title":"The search for genetic modifiers of disease severity in the \u03b2-hemoglobinopathies","volume":"2","author":"Lettre","year":"2012","journal-title":"Cold Spring Harb. Perspect. Med."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"939","DOI":"10.7326\/0003-4819-148-12-200806170-00221","article-title":"Systematic review: Hydroxyurea for the treatment of adults with sickle cell disease","volume":"148","author":"Lanzkron","year":"2008","journal-title":"Ann. Intern. Med."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"80","DOI":"10.1080\/03630269.2021.1904974","article-title":"Clinical Features and Outcome of Sickle Cell Disease in a Tertiary Center in Northern Lebanon: A Retrospective Cohort Study in a Local, Hospital-Associated Registry","volume":"45","author":"Inati","year":"2021","journal-title":"Hemoglobin"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"246","DOI":"10.1016\/j.pain.2009.06.029","article-title":"Pain site frequency and location in sickle cell disease: The PiSCES project","volume":"145","author":"McClish","year":"2009","journal-title":"Pain"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"168","DOI":"10.1016\/S0885-3924(97)00019-5","article-title":"Sickle Cell-Related Pain: Perceptions of Medical Practitioners","volume":"14","author":"Shapiro","year":"1997","journal-title":"J. Pain Symptom Manag."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"746","DOI":"10.1016\/j.jpain.2018.12.003","article-title":"AAAPT Diagnostic Criteria for Acute Sickle Cell Disease Pain","volume":"20","author":"Field","year":"2019","journal-title":"J. Pain"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"S28","DOI":"10.1016\/j.annemergmed.2020.08.009","article-title":"Trends in Sickle Cell Disease\u2013Related Mortality in the United States, 1979 to 2017","volume":"76","author":"Payne","year":"2020","journal-title":"Ann. Emerg. Med."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/6\/2339\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T09:29:22Z","timestamp":1773912562000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/6\/2339"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,19]]},"references-count":28,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2026,3]]}},"alternative-id":["jcm15062339"],"URL":"https:\/\/doi.org\/10.3390\/jcm15062339","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,19]]}}}