| Summary: | Abstract Background and Aims Penicillin V prophylaxis protects children living with sickle cell disease (SCD) from bacteria infections especially Streptococcus pneumonia. However, the uptake of penicillin V prophylaxis is difficult to assess and often poor among SCD patients. Therefore, this study sought to investigate oral penicillin V prophylaxis adherence among SCD children using urine assay and self‐reported methods and the associated factors. Methods The study employed an analytical cross‐sectional design in the assessment of penicillin V prophylaxis adherence using both urine assay and self‐reported methods. Multiple logistic regression analysis was used to determine the factors associated with penicillin V prophylaxis adherence. A p value < 0.05 was considered statistically significant. Results Among the 421 SCD patients recruited, penicillin V prophylaxis adherence was observed to be 30.0% and 68.0% for the objective and subjective methods of assessment, respectively. For the objective method of assessment, being cared for by grandparents increased the odds of penicillin V adherence (adjusted odds ratio [aOR] = 3.68, confidence interval [CI] = 1.03–13.15). However, SCD patients within the ages of 10–14 years (aOR = 0.36, CI = 0.17–0.80), >14 years (aOR = 0.17, CI = 0.05–0.61), SCD patient cared for by married caregivers/parents (aOR = 0.32, CI = 0.14–0.72), SCD patient cared for by divorced caregivers/parents (aOR = 0.23, CI = 0.07–0.75), SCD patients taking homemade (herbal) preparations for the treatment of SCD (aOR = 0.42, CI = 0.21–0.83), and inappropriate intake of penicillin V prophylaxis (aOR = 0.27, CI = 0.11–0.67) reduced the odds of penicillin V adherence. For the subjective method of assessment, taking homemade preparation (herbal) for the treatment of SCD (aOR = 0.52, CI = 0.30–0.89) and inappropriate intake of penicillin V (aOR = 0.32, CI = 0.17–0.60) reduced the odds of penicillin V adherence. Conclusion This study reports a relatively low adherence rate of penicillin V prophylaxis among children living with SCD. Educating and counseling both SCD patients and/or caregivers on the need to be adherent to penicillin V prophylaxis could prevent complications that may arise from nonadherence.
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