Infections, long-term antibiotic use and vaccination in sickle cell: A mixed-methods investigation

Sickle Cell (SC) is a severe genetic disorder that predominantly affects people of African and Caribbean origin. SC is under-researched, and a recent parliamentary inquiry highlighted the urgent need to address health inequalities in SC. Infections remain a major contributor of morbidity and mortality in SC. Although antibiotic prophylaxis and vaccination have improved patient outcomes in SC, clinical guidance on long-term antibiotic use is conflicting. Antimicrobial resistance (AMR) and the extent to which recommendations on these interventions are followed is undocumented. This contributes to the well-documented lack of trust towards the healthcare system amongst the Black community. My aims are to use large-scale UK electronic health records to quantify i) the burden of infections and infection-related complications in SC; ii) trends and associations of long-term antibiotic prescribing and AMR in SC; and iii) assess the coverage of vaccines in SC. Through focus groups and survey co-production with people with SC or those caring for them, I will explore attitudes and barriers towards antibiotic prophylaxis and vaccination in SC. This mixed methods approach will help (re)build trust and inform clinical guidelines to better manage infections in SC, prevent AMR, reduce poor health outcomes and healthcare costs, and improve quality of life.