Siana Nkya1,2,3, Lillian Mtei2,3, Deogratias Soka2,3, Vera Mdai2,3, Promise B Mwakale2,3, Paul Mrosso2,3, Issa Mchoropa3,4, Stella Rwezaula2,5, Mary Azayo6, Nzovu Ulenga7, Melkiory Ngido3,4, Sharon E Cox2,3,8,9, Brenda S D'Mello10, Honorati Masanja11, Gregory S Kabadi6, Frederick Mbuya3, Bruno Mmbando1,3,12, Yvonne Daniel13, Allison Streetly13, Japhet Killewo2, Furahini Tluway2,3, Magdalena Lyimo2,14, Julie Makani2,3. 1. Dar es Salaam University College of Education, Dar es Salaam, Tanzania. 2. Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania. 3. Sickle Cell Program, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania. 4. Delloite and Touche, Dar es Salaam, Tanzania. 5. Muhimbili National Hospital, Dar es Salaam, Tanzania. 6. Ministry of Health, Community Development, Gender, Elderly and Children, Dodoma, Tanzania. 7. Management and Development for Health, Dar es Salaam, Tanzania. 8. Graduate School of Tropical Medicine & Global Health, Nagasaki University, Nagasaki, Japan. 9. Faculty of Epidemiology & Population Health, London School of Hygiene & Tropical Medicine, London, UK. 10. Comprehensive Community Based Rehabilitation in Tanzania (CCBRT), Dar es Salaam, Tanzania. 11. Ifakara Health Institute, Dar es Salaam, Tanzania. 12. National Institute for Medical Research, Tanga Centre, Tanga, Tanzania. 13. Public Health England, NHS Sickle Cell and Thalassemia Screening Programme and National Healthcare Public Health Division, London, UK. 14. National Blood Transfusion service, Dar es Salaam, Tanzania.
Abstract
BACKGROUND: Sickle cell disease (SCD) is a recognized cause of childhood mortality. Tanzania has the fifth highest incidence of SCD (with an estimated 11 000 SCD annual births) worldwide. Although newborn screening (NBS) for SCD and comprehensive healthcare have been shown to reduce under-5 mortality by up to 94% in high-income countries such as the USA, no country in Africa has maintained NBS for SCD as a national health program. The aims of this program were to establish and evaluate NBS-SCD as a health intervention in Tanzania and to determine the birth prevalence of SCD. METHODS: Muhimbili University of Health and Allied Sciences conducted NBS for SCD from January 2015 to November 2016. Dried blood spot samples were collected and tested for SCD using isoelectric focusing. RESULTS: Screening was conducted on 3981 newborns. Thirty-one (0.8%) babies had SCD, 505 (12.6%) had sickle cell trait and 26 (0.7%) had other hemoglobinopathies. Twenty-eight (90.3%) of the 31 newborns with SCD were enrolled for comprehensive healthcare. CONCLUSIONS: This is the first report on NBS as a health program for SCD in Tanzania. The SCD birth prevalence of 8 per 1000 births is of public health significance. It is therefore important to conduct NBS for SCD with enrollment into a comprehensive care program.
BACKGROUND:Sickle cell disease (SCD) is a recognized cause of childhood mortality. Tanzania has the fifth highest incidence of SCD (with an estimated 11 000 SCD annual births) worldwide. Although newborn screening (NBS) for SCD and comprehensive healthcare have been shown to reduce under-5 mortality by up to 94% in high-income countries such as the USA, no country in Africa has maintained NBS for SCD as a national health program. The aims of this program were to establish and evaluate NBS-SCD as a health intervention in Tanzania and to determine the birth prevalence of SCD. METHODS: Muhimbili University of Health and Allied Sciences conducted NBS for SCD from January 2015 to November 2016. Dried blood spot samples were collected and tested for SCD using isoelectric focusing. RESULTS: Screening was conducted on 3981 newborns. Thirty-one (0.8%) babies had SCD, 505 (12.6%) had sickle cell trait and 26 (0.7%) had other hemoglobinopathies. Twenty-eight (90.3%) of the 31 newborns with SCD were enrolled for comprehensive healthcare. CONCLUSIONS: This is the first report on NBS as a health program for SCD in Tanzania. The SCD birth prevalence of 8 per 1000 births is of public health significance. It is therefore important to conduct NBS for SCD with enrollment into a comprehensive care program.
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