Implementing newborn screening for sickle cell disease as part of immunisation programmes in Nigeria: a feasibility study
Implementing newborn screening for sickle cell disease as part of immunisation programmes in Nigeria: a feasibility study
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DOI：
10.1016/s2352-3026(20)30143-5
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发表时间：
2020-07-01
影响因子：
24.7
通讯作者：
Piel, Frederic B.
中科院分区：
文献类型：
--
作者：
Nnodu, Obiageli E.;Sopekan, Alayo;Piel, Frederic B.
背景镰状细胞病在撒哈拉以南非洲地区非常流行，在那里它占相当大的发病率和死亡率。新生儿筛查对于早期诊断和将受影响儿童纳入综合护理方案至关重要。到目前为止，这一战略在资源贫乏的国家受到了很大的损害，因为筛查方法是技术和财政密集型的;需要负担得起的，可靠的和准确的方法。我们的目的是测试实施镰状细胞病筛查计划的可行性，使用创新的即时保健测试设备到现有的免疫接种计划在初级health-care settings.Methods建立在常规免疫接种计划，并利用现有的设施和工作人员，我们做了一个前瞻性的可行性研究，在五个Gwagwalada地区理事会，阿布贾，尼日利亚的初级卫生保健中心。我们使用基于ELISA的床旁检测（HemoTypeSC），对在这五个中心的免疫诊所就诊的连续新生儿和9个月以下的婴儿进行了系统性镰状细胞病筛查。在母亲同意的情况下，前往初级卫生保健中心免疫诊所就诊的连续婴儿亚组接受了HemoTypeSC床旁检测以及不同的基于免疫测定的床旁检测（SickleSCAN）和金标准测试，高效液相色谱法（HPLC）。结果在2017年7月14日和2019年9月3日之间，3603新生儿和婴儿谁提出的免疫接种进行了筛查镰状细胞病在五个初级卫生保健中心使用ELISA为基础的床旁检测。我们确定了51名（1%）镰状细胞贫血（HbSS）儿童，4名（
Background Sickle cell disease is highly prevalent in sub-Saharan Africa, where it accounts for substantial morbidity and mortality. Newborn screening is paramount for early diagnosis and enrolment of affected children into a comprehensive care programme. Up to now, this strategy has been greatly impaired in resource-poor countries, because screening methods are technologically and financially intensive; affordable, reliable, and accurate methods are needed. We aimed to test the feasibility of implementing a sickle cell disease screening programme using innovative point-of-care test devices into existing immunisation programmes in primary health-care settings.Methods Building on a routine immunisation programme and using existing facilities and staff, we did a prospective feasibility study at five primary health-care centres within Gwagwalada Area Council, Abuja, Nigeria. We systematically screened for sickle cell disease consecutive newborn babies and infants younger than 9 months who presented to immunisation clinics at these five centres, using an ELISA-based point-of care test (HemoTypeSC). A subgroup of consecutive babies who presented to immunisation clinics at the primary health-care centres, whose mothers gave consent, were tested by the HemoTypeSC point-of-care test alongside a different immunoassay-based point-of-care test (SickleSCAN) and the gold standard test, high-performance liquid chromatography (HPLC).Findings Between July 14, 2017, and Sept 3, 2019, 3603 newborn babies and infants who presented for immunisation were screened for sickle cell disease at five primary health-care centres using the ELISA-based point-of-care test. We identified 51 (1%) children with sickle cell anaemia (HbSS), four (