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巴西米纳斯吉拉斯州综合新生儿筛查项目中镰状细胞病患儿的存活率。

Survival of children with sickle cell disease in the comprehensive newborn screening programme in Minas Gerais, Brazil.

作者信息

Sabarense Alessandra Palhoni, Lima Gabriella Oliveira, Silva Lívia Maria Lellis, Viana Marcos Borato

机构信息

Center for Newborn Screening and Genetic Diagnosis.

出版信息

Paediatr Int Child Health. 2015;35(4):329-32. doi: 10.1080/20469047.2015.1109235.

Abstract

BACKGROUND

Children in developing countries with sickle cell disease SCD have high rates of mortality, especially in some parts of Africa.

AIM

To compare the 5-year estimated mortality rate in children born between 1999 and 2001 with that of children born between 2009 and 2011.

METHODS

During the period 1998-2012, sickle cell disease was diagnosed in 2591 of 3,617,919 newborns screened in Minas Gerais, Brazil (1 : 1,400). The estimated probability of death [1 - Survival] was calculated by the Kaplan-Meier method. The logrank test was used to compare groups of survival data.

RESULTS

Of the 2576 children (15 were excluded), 193 died (7.4%): 153 (79.3%) had SS/Sβ(0)-thalassaemia, 34 had SC (17.6%), and six (3.1%) had Sβ(+) thalassaemia. The 5-year estimated mortality was lower for children born between 2009 and 2011 (n=509) than for those born between 1999 and 2001 (n=624), although not significantly [mean (SD) 5.8% (1.1) vs 6.2% (1.0)], respectively).

CONCLUSION

Despite an effective ongoing comprehensive screening programme, mortality from SCD in Minas Gerais is still high. To decrease mortality rates, socio-economic development and SCD education programmes for health professionals and families are required.

摘要

背景

发展中国家患有镰状细胞病(SCD)的儿童死亡率很高,尤其是在非洲的一些地区。

目的

比较1999年至2001年出生儿童与2009年至2011年出生儿童的5年估计死亡率。

方法

在1998 - 2012年期间,在巴西米纳斯吉拉斯州筛查的3617919名新生儿中,有2591例被诊断为镰状细胞病(比例为1:1400)。采用Kaplan-Meier方法计算死亡估计概率[1 - 生存率]。使用对数秩检验比较生存数据组。

结果

在2576名儿童(排除15名)中,193名死亡(7.4%):153名(79.3%)患有SS/Sβ(0) - 地中海贫血,34名患有SC(17.6%),6名(3.1%)患有Sβ(+)地中海贫血。2009年至2011年出生的儿童(n = 509)的5年估计死亡率低于1999年至2001年出生的儿童(n = 624),尽管差异不显著[平均(标准差)分别为5.8%(1.1)和6.2%(1.0)]。

结论

尽管正在实施有效的全面筛查计划,但米纳斯吉拉斯州镰状细胞病的死亡率仍然很高。为了降低死亡率,需要社会经济发展以及针对卫生专业人员和家庭的镰状细胞病教育计划。

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