Extremely high birth prevalence of sickle cell disease in rural Tanzania.
Extremely high birth prevalence of sickle cell disease in rural Tanzania.
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DOI：
10.1002/pbc.28620
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发表时间：
2020-11
影响因子：
3.2
通讯作者：
中科院分区：
文献类型：
--
作者：
镰状细胞病（SCD）是全球儿童死亡的一个重要的隐性原因。它在撒哈拉以南非洲最为普遍，那里没有国家新生儿筛查计划，农村地区的大多数儿童从未得到诊断。我们在坦桑尼亚北部的一家农村地区医院进行了一项研究，以确定SCD的出生患病率和社区认知度，并确定使用点护理测试将新生儿纳入新的SCD诊所进行持续治疗的可行性。我们在Shirati KMT医院使用一种廉价的即时检测方法——血型esc对婴儿进行SCD筛查。筛查阳性的婴儿被纳入SCD诊所，并被指示在6-12周后返回进行确认测试、咨询和预防性护理。2019年2月至9月，共有999名新生儿接受了筛查。其中31.6%（315/999）有镰状细胞特征，3.9%（39/999）有SCD。未检测到血红蛋白C。很少有家长知道自己的镰状细胞状况（0.3%）。在完成5个月后，筛查研究中的12名婴儿和另外30名儿童在SCD诊所接受持续的咨询和护理。在坦桑尼亚农村，SCD的出生患病率非常高，而社区的认识很低。新生儿护理点检测提高了病例发现率，使SCD的预防保健得以早期登记，即使在实验室能力最低的撒哈拉以南非洲农村地区也是如此。在地区医院一级实施针对SCD的临床服务，可以扩大对许多儿童的服务范围，并显著降低早期SCD发病率和死亡率。
Sickle cell disease (SCD) is an important, hidden cause of childhood mortality worldwide. It is most prevalent in sub-Saharan Africa where national newborn screening programs remain unavailable and most children in rural areas are never diagnosed. We conducted a study at a rural district hospital in northern Tanzania to determine the birth prevalence and community awareness of SCD and to determine the feasibility of using point-of-care testing to enroll newborns in a new SCD clinic for ongoing treatment. We screened infants at Shirati KMT hospital for SCD using HemoTypeSC, an inexpensive point-of-care test. Infants who screened positive were enrolled in the SCD clinic and instructed to return at 6–12 weeks for confirmatory testing, counseling, and preventive care. A total of 999 newborns were screened from February to September 2019. Among these, 31.6% (315/999) had sickle cell trait and 3.9% (39/999) had SCD. No hemoglobin C was detected. Very few parents knew their own sickle cell status (0.3%). At 5 months after completion, 12 infants from the screening study and 30 additional children had been seen at the SCD clinic for ongoing counseling and care. Birth prevalence of SCD in rural Tanzania is extremely high and community awareness is low. Newborn point-of-care testing enhances case finding and enables early enrollment in preventive care for SCD, even in rural sub-Saharan Africa with minimal laboratory capacity. SCD-specific clinical services implemented at the district hospital level could expand access to many children and significantly reduce early SCD morbidity and mortality.
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影响因子：
20.3
作者：
Rahimy, MC;Gangbo, A;Alihonou, E
通讯作者：
Alihonou, E
影响因子：
12.8
作者：
Steele C;Sinski A;Asibey J;Hardy-Dessources MD;Elana G;Brennan C;Odame I;Hoppe C;Geisberg M;Serrao E;Quinn CT
通讯作者：
Quinn CT
影响因子：
4.6
作者：
Piel, Frederic B.;Howes, Rosalind E.;Patil, Anand P.;Nyangiri, Oscar A.;Gething, Peter W.;Bhatt, Samir;Williams, Thomas N.;Weatherall, David J.;Hay, Simon I.
通讯作者：
Hay, Simon I.
影响因子：
2.8
作者：
Kuznik, Andreas;Habib, Abdulrazaq G.;Lamorde, Mohammed
通讯作者：
Lamorde, Mohammed
影响因子：
20.3
作者：
Quinn, Charles T.;Rogers, Zora R.;Buchanan, George R.
通讯作者：
Buchanan, George R.