Itinéraire Thérapeutique des Patients Drépanocytaires Reçus dans les Services d’Hematologie Clinique du Centre Hospitalier Universitaire de Conakry: Therapeutic itinerary of sickle cell patients in the clinical hematology departments of the University Teaching Hospital of Conakry

RESUMEIntroduction. Les itineraires therapeutiques sont tres fluctuants et la plupart des patients drepanocytaires changent de structures de soins ou de prestataires dans leurs parcours. Notre etude avait pour objectif de contribuer a l’amelioration de la prise en charge de la drepanocytose dans les services d’hematologie du CHU de Conakry par la description de leurs parcours de soins. Methodologie. Il s’agit d’une etude transversale de type descriptif d’une duree de 6 mois, allant du 1er janvier 2020 au 30 juin 2020 portant sur l’itineraire therapeutique des patients drepanocytaires recus dans les services d’hematologie clinique du centre hospitalier et universitaire de conakry. Resultats. Nous avons inclus 109 patients drepanocytaires soit 12,69% des patients recus. Une predominance masculine avec un sex ratio de 1,08. L’âge moyen etait de 27 ans avec des extremes de 3 et 68 ans. Les eleves et etudiants etaient les plus representes (50,96%). Le premier parcours de soins etait l’automedication (42,31 %), puis la consultation en hematologie (28,85%) et la consulation generaliste (20,19%). Le type de traitement suivi etait d’abord un traitement medical (61,54%) suivi de ceux qui n’ont use d’aucun traitement (28,85%). 75% de nos patients etaient referes d’une structure moins specialisee et 25% etaient venus d’eux memes. Les patients se faisaient suivre dans les polycliniques (38,46%), les centres medicaux communaux (32,69%) et les centres specialises (CHU) (28,85%). Le phenotype SSFA2 etait le plus represente (65,38%) suivi des phenotypes A/S (32,39%). Conclusion. La drepanocytose est une maladie chronique avec des complications multiples et variees. Les patients dans leur parcours de soins font intervenir les medecins specialistes et generalistes, des traditherapeutes mais aussi une grande part d’automedication. Une large sensibilisation permettrait de faciliter leurs orientations et de minimiser le retard de prise en charge. ABSTRACTIntroduction. The therapeutic itineraries are highly fluctuating and most patients with sickle cell disease change care structures or providers along the way. The aim of our study was to contribute to improving the management of sickle cell disease in the haematology departments of Conakry University Hospital by assessing their care pathways. Methodology. This was a cross-sectional descriptive study lasting 6 months, from 1 January 2020 to 30 June 2020, on the therapeutic itinerary of patients with sickle cell disease received in the clinical hematology departments of the conakry hospital and university centre. Results. We included 109 patients (12.69%) with sickle cell disease. The sex ratio was 1.08. The average age was 27 years with extremes of 3 and 68 years. Pupils and students represented 50.96% of the sample. The first course of treatment was self-medication (42.31%), then haematology consultation (28.85%) generalist consultation (20.19%). The type of treatment was mainly medical treatment (61.54%), followed by those who did not use any treatment (28.85%). Most patients were referred from a less specialised structure (75%) compared to 25% who came on their own. Patients followed up in polyclinics represented 38.46% of cases followed by those coming from communal medical centers (32.69%) and those from specialised centres (CHU) (28.85%). The SSFA2 phenotype (65.38%) was the most represented, followed by the A/S phenotype (32.39%). Conclusion. Sickle cell disease is a chronic disease and its complications are many and varied. Patients in their course of care involv specialists, general practitioners, traditional therapists but also a large proportion of self-medication. A broad awareness of this issue would facilitate their referral and minimise the delay in care.