263105 A Pilot Study to Measure the Effectiveness of a Neonatal Sickle Cell Screening and Comprehensive Care Program in Kenya

Wednesday, October 31, 2012 : 8:45 AM - 9:00 AM

Chris Roberson, JD/MPH , Indiana Hemophilia & Thrombosis Center, Inc., Indianapolis, IN
Anne Greist, MD , Indiana Hemophilia and Thrombosis Center, Inc., Indianapolis, IN
Whitney Sealls, PhD , Indiana Hemophilia and Thrombosis Center, Inc., Indianapolis, IN
F. Chite Asirwa, MD , Moi Teaching and Referral Hospital, Eldoret, Kenya
Rebecca Evans, LCGC , Indiana Hemophilia & Thrombosis Center, Indianapolis, IN
  
     
Background: Approximately 75% of newly diagnosed sickle cell disease (SCD) cases occur in sub-Saharan Africa. SCD-associated infections make it one of the leading causes of under-five mortality in this region. While resource-abundant countries provide neonatal screening and prophylactic care, few African countries have implemented these services. In 2011, the Indiana Hemophilia and Thrombosis Center, Inc. (IHTC) partnered with Indiana University School of Medicine (IU) and the Academic Model Providing Access to Healthcare (AMPATH) in Eldoret, Kenya to reduce this disparity by implementing a pilot neonatal screening and comprehensive care program for SCD. The objective is to demonstrate the feasibility of implementing and sustaining a hemoglobinopathy newborn screening program in Kenya.

Methods: The program will provide testing, family education and medical intervention to patients diagnosed with a hemoglobinopathy. Isoelectric focusing (IEF) and agarose electrophoresis will be used for screening and confirmatory testing, respectively. Diagnosed infants will be given prophylactic penicillin, immunizations and antimalarial chemoprophylaxis. Patients will be registered with AMPATH, and education, care and follow-up visits systematically tracked. Those with sickle cell trait will be provided appropriate counseling and education.

Results: Laboratory equipment has undergone quality control testing and AMPATH staff has been trained. This program begins in 2012.

Policy Implications: We propose that implementation of a neonatal screening program in Kenya will decrease morbidity and mortality in children with SCD. IEF is a scalable screening method and prophylactic interventions are economical and cost-effective. This program will demonstrate feasibility and serve as a model likely replicable in similar African settings.

Learning Areas:
Advocacy for health and health education
Planning of health education strategies, interventions, and programs

Learning Objectives:
Evaluate the importance and need of piloting a neonatal sickle cell screening program in eastern Africa.

Keywords: International Health, Neonatal Screening

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a certified genetic counselor with experience in counseling neonates diagnosed with genetic diseases. I have lived in East Africa and I have lead or coordinated the development of various public health programs.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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