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床边检测在新生儿镰状细胞病筛查中的应用潜力:坦桑尼亚 HemotypeSC™ 和 sickle SCAN® 的评估。

Potential of point of care tests for newborn screening for sickle cell disease: Evaluation of HemotypeSC™ and sickle SCAN® in Tanzania.

机构信息

Department of Haematology and Blood Transfusion, Muhimbili University of Health and Allied Sciences, Dar es salaam, Tanzania.

Department of Clinical Pharmacology, Muhimbili University of Health and Allied Sciences, Dar es salaam, Tanzania.

出版信息

Int J Lab Hematol. 2022 Oct;44(5):959-965. doi: 10.1111/ijlh.13929. Epub 2022 Jul 1.

Abstract

BACKGROUND

Sickle cell disease (SCD) is an important cause of <5 mortality. In Tanzania, it is estimated up to 11 000 children are born with SCD annually, making this the fifth country with the highest SCD annual births worldwide. The biggest challenge of expanding the service of newborn screening for SCD as the national health intervention in Tanzania is due to the high cost of the currently used assays and lack of rapid screening methods. Therefore, in this study, we assessed the diagnostic accuracy of point-of-care tests for SCD diagnosis in newborns.

AIM

To evaluate the sensitivity and specificity of HemotypeSC™ and sickle SCAN® in diagnosing SCD in newborns.

METHODS

Diagnostic accuracy of HemotypeSC™ and sickle SCAN® were evaluated in comparison to isoelectric focusing as a confirmatory method.

RESULTS

A total of 706 newborns were enrolled in the study. The sensitivity and specificity of HemotypeSC in detecting Hb SS, Hb AS and Hb AA phonotypes was 100%. The sensitivity and specificity of sickle SCAN® in detecting Hb SS, Hb AS and Hb AA phenotypes were 100%, 97% and 100% respectively.

CONCLUSION

Both POC tests displayed high accuracy in detecting SCD, we believe the introduction of either of these tests in health facilities will help in the early detection and management of SCD. In addition, the margin of cost per test is relatively affordable (1.4$ per test for HemotypeSC™ and 4.75$ for sickle SCAN®).

摘要

背景

镰状细胞病(SCD)是导致<5%死亡率的重要原因。在坦桑尼亚,估计每年有多达 11000 名儿童患有 SCD,使其成为全球 SCD 年出生人数第五高的国家。在坦桑尼亚将新生儿 SCD 筛查作为国家卫生干预措施扩大服务范围所面临的最大挑战是由于目前使用的检测方法成本高昂且缺乏快速筛查方法。因此,在这项研究中,我们评估了即时检测用于新生儿 SCD 诊断的诊断准确性。

目的

评估 HemotypeSC™和 sickle SCAN®在诊断新生儿 SCD 方面的灵敏度和特异性。

方法

将 HemotypeSC™和 sickle SCAN®的诊断准确性与等电聚焦作为确证方法进行比较进行评估。

结果

共有 706 名新生儿入组本研究。HemotypeSC 检测 Hb SS、Hb AS 和 Hb AA 表型的灵敏度和特异性均为 100%。sickle SCAN®检测 Hb SS、Hb AS 和 Hb AA 表型的灵敏度和特异性分别为 100%、97%和 100%。

结论

两种 POCT 检测均显示出检测 SCD 的高准确性,我们相信在医疗机构中引入这些检测中的任何一种都将有助于早期发现和管理 SCD。此外,每个检测的成本边际相对负担得起(HemotypeSC™每个检测 1.4 美元,sickle SCAN®每个检测 4.75 美元)。

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