Sickle Cell Disease and Its Psychosocial Burdens in Africa

In Africa, sickle cell disorder (SCD), an autosomal recessive genetic disorder, has been recognized as a public health priority by the World Health Organization (WHO). Although progress has been made in the management of the disease, much of this is yet to be fully leveraged in many parts of Africa, with the result that the complications often lead to frequent hospital admissions. Among these complications are psychosocial challenges including common mental health and substance use disorders. Prolonged and perhaps lifelong psychological distress are comorbidities associated with living with SCD worldwide, and their burdens need to be examined. Hence, the focus on the psychosocial dimensions of the illness is necessary to achieve a better quality of life for SCD patients and their families. Psychosocial comorbidities are common in SCD and can strongly influence disease outcomes. Depression, anxiety, neurocognitive, and substance use challenges are common comorbidities. This chapter examines the relationship between SCD and mental health across different regions in Africa. In addition, literature on the epidemiology of mental disorders including substance use problems among persons who live with sickle cell disorders (WLCSD) is reviewed to highlight priorities for mental health and substance use burdens across lifespans and regions. Moreover, the impact of stigma and other risk factors for mental health and substance use problems among persons with SCD is also examined. The implications for clinical practice, policy, and research directions are further discussed.