Prevalence of Hemoglobin-S and Baseline Level of Knowledge on Sickle Cell Disease Among Pregnant Women Attending Antenatal Clinics in Dar-Es-Salaam, Tanzania.
Prevalence of Hemoglobin-S and Baseline Level of Knowledge on Sickle Cell Disease Among Pregnant Women Attending Antenatal Clinics in Dar-Es-Salaam, Tanzania.
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DOI：
10.3389/fgene.2022.805709
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发表时间：
2022
影响因子：
3.7
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中科院分区：
文献类型：
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背景：镰状细胞病（SCD）是全球儿童死亡最重要的单一遗传病因。新生儿筛查（NBS）是推荐的干预措施，旨在早期识别患有镰状细胞病的婴儿，并将其与医疗护理相衔接。为确保新生儿筛查取得成功，孕妇需要掌握有关镰状细胞病的必要知识，从而有动力为其婴儿进行筛查。
目的：本研究旨在确定坦桑尼亚达累斯萨拉姆市城区产前诊所就诊孕妇中血红蛋白S的流行率，并评估她们对镰状细胞病的基线认知水平。
方法：本横断面研究于2020年8月至2021年2月开展，研究对象为600名孕周在20 - 28周、于坦桑尼亚达累斯萨拉姆市布古鲁尼健康中心、姆巴加拉医院和辛扎医院产前诊所就诊的孕妇。我们向所有参与者发放了一份结构化问卷，以评估其社会人口学特征以及对镰状细胞病的基线认知水平，10道问题中得分7分及以上者被视为认知良好。我们使用镰状细胞即时检验（美国BioMedomics公司）对来自两个中心（布古鲁尼健康中心和姆巴加拉医院）的300名参与者进行了镰状细胞病筛查。我们使用SPSS 23版软件对数据进行分析。在确定认知水平与社会人口学因素之间的关联时，我们采用皮尔逊卡方检验和多因素逻辑回归来确定关联强度。
结果：600名参与者中，大多数年龄在26至35岁之间（51%），生育1 - 3个孩子的占55.8%，接受过中等教育的占43%，56%为个体经营者。只有14.7%的人对镰状细胞病有良好认知。大多数参与者曾听说过镰状细胞病（81.3%），其中多数人是从街头听闻（42.4%），只有2.4%是从医院得知。在600名研究参与者中，只有2人（0.3%）知晓自己的镰状细胞病患病状况，7.7%称有镰状细胞病家族史。对镰状细胞病的较高认知水平与高学历、职业以及知晓个人镰状细胞病患病状况相关。在接受镰状细胞病筛查的300名参与者中，252人血红蛋白类型为Hb - AA（84%），47人是Hb - AS（15.7%），1人（0.3%）为Hb - SS。
结论：尽管在坦桑尼亚城区产前诊所就诊的孕妇中血红蛋白S流行率较高，但她们对镰状细胞病以及个人镰状细胞病患病状况的认知水平较低。应将孕妇镰状细胞病筛查和相关健康教育纳入产前诊所健康促进综合方案。
Background: Sickle cell disease (SCD) is the single most important genetic cause of childhood mortality globally. Newborn screening (NBS) is the recommended intervention aimed at early identification of babies with SCD and their linkage to care. To ensure success of NBS, pregnant women need to have the required knowledge on SCD and therefore motivation to screen their babies. Objective: The aim of this study was to determine the prevalence of hemoglobin-S and assess the baseline level of knowledge on SCD among pregnant women attending antenatal clinics in urban settings in Dar-es-Salaam, Tanzania. Methods: This cross-sectional study was conducted between August 2020 and February 2021, involving 600 pregnant women at 20–28 weeks of gestation attending antenatal clinics at Buguruni Health Center, Mbagala Hospital, and Sinza Hospital in Dar-es-Salaam, Tanzania. We administered a structured questionnaire to all participants to assess socio-demographic characteristics and baseline level of knowledge on SCD, where those scoring 7 or higher out of 10 questions were considered to have good knowledge. We screened for SCD a total of 300 participants from two centers (Buguruni Health Center and Mbagala Hospital) by using Sickle SCAN point-of-care test (BioMedomics Inc., United States). We used SPSS version 23 to analyze the data. On determining the association between level of knowledge and socio-demographic factors, we used Pearson’s Chi-square and multivariate logistic regression in ascertaining the strength of associations. Results: Of the 600 participants, the majority were of the age between 26 and 35 years (51%), with the parity of 1-3 children (55.8%) and secondary level of education (43%), while 56% were self-employed. Only 14.7% had good knowledge on SCD. The majority of the participants had ever heard of SCD (81.3%), most of them heard from the streets (42.4%), and only 2.4% heard from hospitals. Of all 600 study participants, only 2 (0.3%) knew their SCD status while 7.7% declared having a family history of SCD. A proficient level of knowledge on SCD is associated with a high level of education, occupation, and knowing personal status of SCD. Among 300 participants who were screened for SCD, 252 were Hb-AA (84%), 47 were Hb-AS (15.7%), and 1 (0.3%) was Hb-SS. Conclusion: Despite the high prevalence of hemoglobin-S among pregnant women attending antenatal clinics in urban settings in Tanzania, there is a poor level of knowledge on SCD and personal knowledge of SCD status. Maternal screening and health education on SCD should be included as part of the comprehensive package for health promotion at antenatal clinics.
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