\documentclass[10pt]{article}

\usepackage{fullpage}
\usepackage{setspace}
\usepackage{parskip}
\usepackage{titlesec}
\usepackage[section]{placeins}
\usepackage{xcolor}
\usepackage{breakcites}
\usepackage{lineno}
\usepackage{hyphenat}





\PassOptionsToPackage{hyphens}{url}
\usepackage[colorlinks = true,
            linkcolor = blue,
            urlcolor  = blue,
            citecolor = blue,
            anchorcolor = blue]{hyperref}
\usepackage{etoolbox}
\makeatletter
\patchcmd\@combinedblfloats{\box\@outputbox}{\unvbox\@outputbox}{}{%
  \errmessage{\noexpand\@combinedblfloats could not be patched}%
}%
\makeatother


\usepackage{natbib}




\renewenvironment{abstract}
  {{\bfseries\noindent{\abstractname}\par\nobreak}\footnotesize}
  {\bigskip}

\titlespacing{\section}{0pt}{*3}{*1}
\titlespacing{\subsection}{0pt}{*2}{*0.5}
\titlespacing{\subsubsection}{0pt}{*1.5}{0pt}


\usepackage{authblk}


\usepackage{graphicx}
\usepackage[space]{grffile}
\usepackage{latexsym}
\usepackage{textcomp}
\usepackage{longtable}
\usepackage{tabulary}
\usepackage{booktabs,array,multirow}
\usepackage{amsfonts,amsmath,amssymb}
\providecommand\citet{\cite}
\providecommand\citep{\cite}
\providecommand\citealt{\cite}
% You can conditionalize code for latexml or normal latex using this.
\newif\iflatexml\latexmlfalse
\providecommand{\tightlist}{\setlength{\itemsep}{0pt}\setlength{\parskip}{0pt}}%

\AtBeginDocument{\DeclareGraphicsExtensions{.pdf,.PDF,.eps,.EPS,.png,.PNG,.tif,.TIF,.jpg,.JPG,.jpeg,.JPEG}}

\usepackage[utf8]{inputenc}
\usepackage[ngerman,greek,english]{babel}



\usepackage{float}








\begin{document}

\title{HEALTH RELATED QUALITY OF LIFE OF PATIENTS WITH SICKLE CELL DISEASE AGED
8-17 YEARS AT KAMUZU CENTRAL HOSPITAL, MALAWI}



\author[1]{Stella Wachepa}%
\author[2]{Ruth Bvalani}%
\author[1]{Atupele Mpasa}%
\author[1]{Shamim Namugerwa}%
\author[1]{Teddy Namubiru}%
\author[1]{Gloria Kaudha}%
\author[1]{Deogratias Munube}%
\author[1]{Joseph Rujumba}%
\author[3]{Nmazuo Ozuah}%
\author[1]{Sarah Kiguli}%
\affil[1]{Makerere University College of Health Sciences}%
\affil[2]{Kamuzu Central Hospital}%
\affil[3]{Texas Children's Hospital}%


\vspace{-1em}



  
  \date{June 17, 2024}


\begingroup
\let\center\flushleft
\let\endcenter\endflushleft
\maketitle
\endgroup





\selectlanguage{english}
\begin{abstract}
Background: Sickle cell disease (SCD) is characterized by both acute and
chronic complications that affect the daily lives of patients and lower
their quality of life. Objective: To describe the health-related quality
of life (HRQoL) and the associated factors in children aged 8 to 17 with
SCD attending the paediatric haematology clinic at Kamuzu Central
Hospital (KCH) in Lilongwe, Malawi. Methods: A mixed methods cross
sectional study was conducted at KCH. Patient data was collected with
the aid of a standardized case report form. HRQoL was assessed using
PedsQL Sickle Cell Disease Module by child's report. Associations
between HRQoL scores and independent variables were evaluated by a
linear regression model. In-depth interviews were then carried out and
the qualitative data was analyzed using content thematic analysis.
Results: A hundred and sixty-three children with SCD were enrolled,
52.1\% were females. Their median age was 11.2\selectlanguage{ngerman}±2.7 years. The mean
global HRQoL score of the children was 62±17.3. The highest scores were
in the treatment domain (72.5±15.1) while the lowest scores were in the
emotions domain (55.2±28.7). The mean pain score was 58.8±16.3. The
factors associated with low HRQoL scores were pain (\selectlanguage{greek}β-\selectlanguage{english}coefficient -6.97
CI (-3.07,-15.58); p value 0.034) and low haemoglobin levels
(\selectlanguage{greek}β-\selectlanguage{english}coefficient 2.29 CI (0.65-3.91); p value 0.006 ). Conclusion: The
HRQoL of this population is low. Pain and low hemoglobin were
significantly associated with low HRQoL scores. A biopsychosocial model
of heath care delivery and health campaigns are recommended to improve
the HRQoL of the children.%
\end{abstract}%



\sloppy


\textbf{Hosted file}

\verb`Manuscript_Stella Wachepa for PBC.doc`  available at \url{https://authorea.com/users/460475/articles/556469-health-related-quality-of-life-of-patients-with-sickle-cell-disease-aged-8-17-years-at-kamuzu-central-hospital-malawi}

\selectlanguage{english}
\FloatBarrier
\end{document}

