Pediatric Emergency Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University, Illinois, USA.
J Natl Med Assoc. 2012 May-Jun;104(5-6):299-304. doi: 10.1016/s0027-9684(15)30155-3.
Sickle cell disease (SCD) is found in many ethnic groups, with the highest prevalence of heterozygote ' carriers (sickle cell trait [SCT]) in African Americans. SCT is associated with an increased risk of fatal exertional heat illness, renal papillary necrosis, and splenic infarction. Since 2006, all infants born in the United States are required to be screened for hemoglobinopathies as part of newborn screening (NBS). In 2010, as part of a legal settlement, the National Collegiate Athletic Association (NCAA) implemented SCT screening in division I athletes.
Members of the American Academy of Pediatrics (AAP) Section on Young Physicians were sent up to 4 e-mail survey requests to evaluate SCT education during residency, current NBS follow-up practice, and awareness of the NCAA policy. Descriptive statistics and chi2 analyses were performed.
Of 871 eligible participants, 355 (41%) completed the survey. Respondents were 70% female, 71% white, and 79% general pediatricians. Most had experience with SCD during residency and had been taught about the medical and reproductive implications of SCT. Virtually all pediatricians report SCT to families when identified during NBS, but only 59% order confirmatory testing (e.g., hemoglobin electrophoresis) to verify status. While 93% counsel about reproductive implications of SCT, only 71% counsel about other medical implications. Only 27% were aware of the NCAA policy.
Despite formal SCT education, a significant number of pediatricians do not verify NBS results or counsel about the medical implications of SCT. More comprehensive AAP guidelines about SCT are needed and must be incorporated into residency education.
镰状细胞病（SCD）存在于许多种族群体中，其中非裔美国人中杂合子“携带者（镰状细胞特征[SCT]）的患病率最高。SCT 与致命性运动性热疾病、肾乳头坏死和脾梗死的风险增加有关。自 2006 年以来，美国所有新生儿都需要作为新生儿筛查（NBS）的一部分筛查血红蛋白病。2010 年，作为法律和解的一部分，全国大学生体育协会（NCAA）在 I 级运动员中实施了 SCT 筛查。
儿科学会（AAP）青年医生科的成员收到了多达 4 封电子邮件调查请求，以评估住院医师期间的 SCT 教育、当前 NBS 随访实践以及对 NCAA 政策的认识。进行了描述性统计和 chi2 分析。
在 871 名符合条件的参与者中，有 355 名（41%）完成了调查。受访者中 70%为女性，71%为白人，79%为普通儿科医生。大多数人在住院医师期间有 SCD 经验，并且已经了解 SCT 的医疗和生殖影响。几乎所有儿科医生在 NBS 期间发现 SCT 时都会向家属报告，但只有 59%会进行确认性检测（例如血红蛋白电泳）以验证状态。尽管 93%的人会就 SCT 的生殖影响进行咨询，但只有 71%的人会咨询其他医疗影响。只有 27%的人知道 NCAA 的政策。
尽管有正规的 SCT 教育，但相当数量的儿科医生不会验证 NBS 结果或咨询 SCT 的医疗影响。需要制定更全面的 AAP 关于 SCT 的指南，并将其纳入住院医师教育。
