Background/Objective: Sickle cell disease (SCD) exacts a heavy psychosocial toll on caregivers in resource-limited settings like Nigeria, where mental health integration in paediatric care remains sparse. This study assessed the prevalence and predictors of depression and anxiety among family caregivers of children with SCD in Abia State, aiming to inform targeted public health interventions.

Methods: A multicentre cross-sectional study was conducted from June to August 2025 at three referral hospitals in Abia State, Nigeria. Using consecutive sampling, 384 eligible primary caregivers (≥18 years) of children (<18 years) with confirmed SCD were interviewed. Depression and anxiety were screened using the Patient Health Questionnaire-9 (PHQ-9; cutoff ≥10) and Generalised Anxiety Disorder-7 (GAD-7; cutoff ≥10). Sociodemographic, caregiving, and disease-related variables were collected through structured questionnaires. Multivariable logistic regression identified predictors (p<0.05), adhering to STROBE guidelines. Ethical approval was secured from the Abia State Health Research Ethics Committee (AB/MH/PRS/ECS/T.1/1016).

Results: Participants were predominantly female (78.4%) and mothers (75.3%), with a mean age of 36.4 years (SD 7.2); 66.7% had monthly incomes <₦50,000 (<$35). Depression prevalence was 41.7% (95% CI: 36.9-46.5) and anxiety 35.2% (95% CI: 30.6-39.8), with 28.1% comorbidity. Independent predictors of depression included low income (OR=2.45, 95% CI: 1.62-3.71), caregiving >5 years (OR=1.89, 95% CI: 1.24-2.88), and child hospitalizations ≥3/year (OR=2.12, 95% CI: 1.41-3.19). For anxiety, female gender (OR=1.67, 95% CI: 1.05-2.65) and rural residence (OR=1.74, 95% CI: 1.12-2.70) were significant (Nagelkerke R²=0.25-0.28).