Psychosocial impact of leg ulcers on the quality of life of adults living with sickle cell disease in Ghana

Background: Sickle cell disease-related persistent chronic manifestations, such as leg ulcers, continue to raise clinical and psychosocial concerns. The Quality of Life (QoL) issues have not been adequately defined in sickle cell disease (SCD) management. This study examined the psychosocial effects of leg ulcers in people living with SCD in Ghana. Methods: A total of 95 adult SCD patients aged 18–65 participated in the cross-sectional study, with 41 having chronic leg ulcers and 54 without leg ulcers. Participants were administered the Sickle Cell Illness Impact Measurement Scale (SIMS) to assess five main domains of QoL: general health perception, physical functioning, social functioning, emotional well-being, and quality of care. The Analysis of Covariance (ANCOVA) test was used to determine the differences in the quality of life between the groups while controlling for the effect of genotype, gender, and age. The multivariate logistic regression was conducted to identify the clinical and demographic predictors of QoL among adult SCD by examining the relationships between multiple independent variables and a binary QoL outcome. Results: Generally, SCD patients without leg ulcers had an overall good QoL (p = 0.017), functioned better socially (p < 0.001) and had good general health perception (p = 0.012) than their counterparts with leg ulcers. Patient’s age at registration at clinic [aOR = 1.062 (95%CI 1.01, 1.12) p = 0.022], having a Sickle Cell Leg Ulcer (SCLU) [aOR = 3.716 (95%CI 1.44, 9.62) p = 0.007] predicted poorer QoL of the SCD population. Conclusion: These findings have significant clinical implications. Integrating early, enhanced and targeted interventions into the clinical management of SCD patients, especially those with sickle cell leg ulcers, is crucial to improving their quality of life.