Comparison of Determinants of Enuresis among Children and Adolescents Living with HIV/AIDS and Children and Adolescents Living with Sickle Cell Disease in Maiduguri: A Critical Nigerian Research Article

Abstract

Introduction: Enuresis is a common but often hidden paediatric condition. It becomes clinically more important when it occurs in children and adolescents with chronic illnesses such as HIV/AIDS and sickle cell disease (SCD), where biological vulnerability, sleep disruption, stigma, family stress and repeated clinic contact may interact. This study compares the prevalence and determinants of enuresis among children and adolescents living with HIV/AIDS and those living with SCD attending specialist clinics in Maiduguri, Nigeria. Methodology: This manuscript reframes and strengthens a comparative cross-sectional study conducted among 320 participants aged 6-18 years, with 160 children/adolescents living with HIV/AIDS and 160 living with SCD. Participants were age- and sex matched. Enuresis was assessed using the screening and diagnostic components of the Kiddie Schedule for Affective Disorders and Schizophrenia for School-Age Children, Present and Lifetime Version. Clinical data were extracted from case notes. The review further interprets the findings using published literature on paediatric enuresis, sickle cell nephropathy, adolescent HIV, chronic illness and Islamic psychoeducational care. Results: The mean age was 11.4 years (SD 3.15), and males constituted 51.9% of participants in each group. Current nocturnal enuresis was more common among children/adolescents with SCD than among those with HIV/AIDS: 28.8% (95% CI 22.23 36.30) versus 22.5% (95% CI 16.65-29.67). Among the SCD group, disease awareness, medication adherence and family history of mental illness were associated with nocturnal enuresis in bivariate analysis, while awareness of SCD independently predicted lower odds of nocturnal enuresis (OR 0.26; 95% CI 0.08-0.82; p=0.022). Conclusion: Enuresis is a substantial, under-recognised clinical and psychosocial problem among children and adolescents with HIV/AIDS and SCD in Maiduguri, with a higher burden among those with SCD. Routine screening, non-punitive family education, disease-specific care, school support and culturally sensitive Islamic psychoeducation should be integrated into paediatric HIV and SCD clinics in Nigeria.