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布滕博和贝尼新生儿镰状细胞病筛查:刚果民主共和国高地地区的试点经验。

Newborn screening for sickle cell disease in Butembo and Beni: a pilot experience in a highland region of the Democratic Republic of Congo.

机构信息

Department of Pediatrics, Faculty of Medicine, Catholic University of Graben, Butembo, Democratic Republic of the Congo.

Department of Internal Medicine, Faculty of Medicine and Pharmacy, University of Kisangani, Kisangani, Democratic Republic of the Congo.

出版信息

Pan Afr Med J. 2023 May 24;45:56. doi: 10.11604/pamj.2023.45.56.36087. eCollection 2023.

Abstract

INTRODUCTION

sickle cell disease is an inherited autosomal recessive hemoglobin disorder resulting in acute and chronic systemic complications. Despite the high burden of sickle cell disease in the Democratic Republic of the Congo, limited data on disease prevalence is available and systematic screening is not offered to newborns. This study aimed to provide neonatal prevalence and associated factors to the phenotypic manifestation of sickle cell disease in an eastern region of the Democratic Republic of the Congo.

METHODS

the study was conducted from 20 April 2021 to 20 January 2022 in the cities of Beni and Butembo, involving live full-term newborns whose parents consented to participate. Blood was taken with heel pricks and analyzed using the point-of-care diagnostic tool HemoTypeSC™. We used Fisher´s exact test to compare frequencies between groups. P-value <0.05 was considered statistically significant. of the 1195 newborns screened, 1122 (93.9%) were tested as having hemoglobin AA, 71 (5.9%) hemoglobin AS, 2 (0.2%) hemoglobin SS and none hemoglobin C. The mother´s ethnicity was significantly associated with the phenotypic expression of sickle cell disease.

CONCLUSION

sickle cell disease prevalence is lower in Butembo and Beni than in other regions of the Democratic Republic of the Congo. However, it remains an alarming public health issue. Systematic newborn screening, parent/patient education and early management programs constitute an urgent need to be addressed by decision-makers.

摘要

引言

镰状细胞病是一种遗传性常染色体隐性血红蛋白疾病,可导致急性和慢性全身性并发症。尽管刚果民主共和国的镰状细胞病负担很高,但可用的疾病流行数据有限,且并未向新生儿提供系统筛查。本研究旨在为刚果民主共和国东部地区的镰状细胞病表型表现提供新生儿患病率及其相关因素。

方法

本研究于 2021 年 4 月 20 日至 2022 年 1 月 20 日在贝尼和布滕博市进行,涉及同意参与的活足月新生儿。采用足跟采血,使用即时诊断工具 HemoTypeSC™进行分析。我们使用 Fisher 精确检验比较组间频率。P 值<0.05 被认为具有统计学意义。在筛查的 1195 名新生儿中,1122 名(93.9%)检测为血红蛋白 AA,71 名(5.9%)血红蛋白 AS,2 名(0.2%)血红蛋白 SS,无血红蛋白 C。母亲的种族与镰状细胞病的表型表达显著相关。

结论

与刚果民主共和国其他地区相比,布滕博和贝尼的镰状细胞病患病率较低。然而,这仍然是一个令人震惊的公共卫生问题。系统的新生儿筛查、家长/患者教育和早期管理计划是决策者急需解决的问题。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aba9/10460112/e0a20c58c249/PAMJ-45-56-g001.jpg

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