Department of Community Health and Primary Care, College of Medicine, University of Lagos, Lagos, Nigeria.
Department of Haematology and Blood Transfusion, College of Medicine, University of Lagos, Lagos, Nigeria.
PLoS One. 2020 Dec 3;15(12):e0242861. doi: 10.1371/journal.pone.0242861. eCollection 2020.
In Nigeria, about 150000 babies are born annually with sickle cell disease (SCD), and this figure has been estimated to increase by 100% by the year 2050 without effective and sustainable control strategies. Despite the high prevalence, newborn screening for SCD which allows for early prophylactic treatment, education of parents/guardians and comprehensive management is not yet available. This study explored a strategy for screening in early infancy during the first and second immunization visits, determined the prevalence, feasibility and acceptability of early infant screening for SCD and the evaluation of the HemoTypeSC diagnostic test as compared to the high-performance liquid chromatography (HPLC) gold standard. A cross-sectional study was conducted in two selected primary health care centres in Somolu local government area (LGA) in Lagos, Nigeria. Two hundred and ninety-one mother-infant pairs who presented for the first or second immunization visit were consecutively enrolled in the study following written informed consent. The haemoglobin genotype of mother-infant pairs was determined using the HemoTypeSC rapid test kit. Confirmation of the infants' Hb genotype was done with HPLC. Data were analysed with SPSS version 22. Validity and Predictive value of HemotypeSC rapid screening test were also calculated. Infant screening for SCD was acceptable to 86% of mothers presenting to the immunization clinics. The prevalence of SCD among the infant cohort was 0.8%. The infants diagnosed with SCD were immediately enrolled in the paediatric SCD clinic for disease-specific care. The HemoTypeSC test had 100% sensitivity and specificity for sickle cell disease in early infancy compared to HPLC. This study affirms that it is feasible and acceptable for mothers to implement a SCD screening intervention program in early infancy in Lagos State. The study also demonstrates the utility of the HemotypeSC rapid testing for ease and reduced cost of screening infants for SCD.
在尼日利亚，每年约有 15 万名婴儿出生时患有镰状细胞病（SCD），如果没有有效的可持续控制策略，到 2050 年，这一数字预计将增加 100%。尽管患病率很高，但新生儿 SCD 筛查可以进行早期预防性治疗、家长/监护人教育和综合管理，但尚未普及。本研究探讨了一种在婴儿早期（第 1 次和第 2 次免疫接种期间）进行筛查的策略，确定了早期婴儿 SCD 筛查的流行率、可行性和可接受性，并评估了 HemoTypeSC 诊断测试与高性能液相色谱法（HPLC）金标准的比较。本研究在尼日利亚拉各斯 Somolu 地方政府区（LGA）的两个选定的初级保健中心进行了一项横断面研究。在获得书面知情同意后，连续纳入了 291 对前来进行第 1 次或第 2 次免疫接种的母婴对。使用 HemoTypeSC 快速检测试剂盒确定母婴对的血红蛋白基因型。使用 HPLC 确认婴儿的 Hb 基因型。使用 SPSS 版本 22 分析数据。还计算了 HemoTypeSC 快速筛查试验的有效性和预测值。婴儿 SCD 筛查被 86%前来免疫接种诊所的母亲接受。婴儿队列中 SCD 的患病率为 0.8%。被诊断患有 SCD 的婴儿立即被纳入儿科 SCD 诊所进行疾病特异性护理。与 HPLC 相比，HemoTypeSC 试验在婴儿早期对镰状细胞病具有 100%的灵敏度和特异性。这项研究证实，在拉各斯州，母亲可以在婴儿早期实施 SCD 筛查干预计划，这是可行和可接受的。该研究还证明了 HemoTypeSC 快速检测用于婴儿 SCD 筛查的便利性和降低成本的实用性。
