Newborn screening for sickle cell disease: an innovative pilot program to improve child survival in Dar es Salaam, Tanzania
Newborn screening for sickle cell disease: an innovative pilot program to improve child survival in Dar es Salaam, Tanzania
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DOI：
10.1093/inthealth/ihz028
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发表时间：
2019-11-01
影响因子：
2.5
通讯作者：
Makani, Julie
中科院分区：
文献类型：
--
作者：
Nkya, Siana;Mtei, Lillian;Makani, Julie
背景：镰状细胞病（SCD）是公认的儿童死亡原因。坦桑尼亚是全球 SCD 发病率第五高的国家（估计每年有 11 000 名 SCD 新生儿）。尽管在美国等高收入国家，SCD 新生儿筛查 (NBS) 和综合医疗保健已被证明可将 5 岁以下儿童死亡率降低高达 94%，但非洲没有一个国家将 SCD 新生儿筛查 (NBS) 作为国家卫生计划。该计划的目的是建立和评估 NBS-SCD 作为坦桑尼亚的健康干预措施，并确定 SCD 的出生患病率。方法：Muhimbili 健康与联合科学大学于 2015 年 1 月至 2016 年 11 月进行了 SCD 的 NBS。收集干血斑样本并使用等电聚焦检测 SCD。结果：对 3981 名新生儿进行了筛查。 31 名 (0.8%) 婴儿患有 SCD，505 名 (12.6%) 婴儿患有镰状细胞性状，26 名 (0.7%) 婴儿患有其他血红蛋白病。 31 名患有 SCD 的新生儿中，有 28 名 (90.3%) 参加了综合医疗保健。结论：这是坦桑尼亚第一份关于 NBS 作为 SCD 健康计划的报告。每 1000 名新生儿中有 8 名 SCD 出生患病率具有公共卫生意义。因此，对 SCD 进行 NBS 并纳入综合护理计划非常重要。
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.