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Comparison of sickle cell disease pain burden in the United States and Africa: the Casire Cohort

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source: The Journal of Pain

year: 2014

authors: W. Zempsky, J. Santanelli, B. Andemariam, D. Manwani, F. Sey, C. Antwi-Boasiako, R. Urbonya, A. Campbell


Sickle cell disease (SCD) is a recessive genetic blood disorder that is hallmarked by pain. The Consortium for the Advancement of Sickle Cell Research (CASIRE) is an international collaborative research group with sites in the United States, Europe, and Africa. Given the lack of access to analgesics it may be that pain has a greater impact in SCD patients in Africa than the industrialized world. Using data from the CASIRE Renal Cohort we sought to compare the impact of pain in individuals with SCD in the US (4 sites) and Africa (1 site). The Sickle Cell Pain Burden Interview (SCPBI) is a is a brief 7-item functional assessment tool validated specifically in SCD that measures pain impact over the previous 4 weeks. Scores on the SCPBI range from 0 to 28 — with higher scores indicating a higher pain burden. 146 participants with SCD [US (n=83), Africa (n=63)] completed a self-reported medical history and SCPBI. Data was collected once in a clinic setting, when patients were at least 2 weeks from a vasoocclusive event. Among the participants from the United States, mean age was 21.3 years (σ=11.4), 75% had HgSS, 60% were female, 93% reported their race as being Black, and mean pain burden was 6.3(σ=6.1). Among the participants from Africa, mean age was 28.2 years (σ=11.1), 76% had HgSS, 55% were female, and mean pain burden was 5.3 (σ=4.8). There was no significant difference in mean SCPBI scores between participants from Africa and the US, nor were there differences in the distribution of pain burden in these 2 groups (X2(4,n=146)=7.45, p=0.1). There was also no difference in SCPBI between US and African participants when stratified by sex. Pain impact when assessed by a SCD specific measure does not differ between individuals with SCD in the US and Africa.

organisation: Connecticut Children's Medical Center, Hartford, CT

DOI: 10.1016/j.jpain.2014.01.136

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