Why Tanzania should invest in newborn screening for Sickle Cell
What you need to know:
The government has previously reported to have included Sickle Cell Disease as a priority condition in the strategy for management of Non-Communicable Diseases (NCDs).
Dar es Salaam. Researchers in Tanzania say a number of deaths attributed to Sickle Cell Disease (SCD) can be significantly reduced if more investment is put in screening new born babies for the disease.
New Born Screening (NBS) for SCD is one of the major topics expected to be highlighted tomorrow(Wednesday, September 25) as researchers on Non-Communicable Diseases(NCDs) gather for the fourth University-wide Symposium at Muhimbili University of Health and Allied Sciences.
Dr Emmanuel Balandya, a senior lecturer at Muhas and a researcher on SCD will showcase his findings on the disease during the symposium.
This year’s theme is Walking together in the Prevention and Control of Non-Communicable Diseases in Tanzania.
The symposium, to be graced by the Chief Medical Officer Prof Muhammad Bakari, is expected address a wide range of issues to do with NCDs in Tanzania. Researchers on heart and kidney diseases, cancer and generally on lifestyle diseases will present papers.
Dr Balandya who is also a Principal Investigator in Sickle Cell Program told The Citizen ahead of the symposium that there are a number of babies who die of Sickle Cell Disease in Tanzania; well before doctors can diagnose them with the disease.
He spoke generally on SCD and its magnitude but dwelt on newborn screening for disease; highlighting why it matters for the country in the current times and for the future.
“Most sickle cell patients are diagnosed above the age of two years. This is a big problem…because they start getting sick earlier, often at the age of five to six months,’’ he explains.
“They [patients] come to hospital with problems that are not specific to sickle cell, such as severe bacterial infections, meningitis, pneumonia, severe anaemia and other complications of sickle cell disease.”
“By not having an early diagnosis it means that a lot of babies are dying below the age of two years, actually before the diagnosis of sickle cell is made,” emphasizes Dr Balandya.
Studies show Tanzania ranks high in cases of SCD; a group of blood disorders which are inherited from a person’s with the most common being sickle-cell anaemia (SCA).
Recent estimates suggest that 10,742 children affected by SCD under the age of five in the country; represent 6.6 per cent of the overall deaths occurring under the age of five, yet key services such as new born screening aren’t highly prioritized here.
NBS has been shown to reduce deaths in children under the age of five by 70 per cent in high income countries but countries in Africa are yet to introduce the screening services as a health intervention.
“…western countries introduced newborn screening for sickle cell disease and what follows after screening is linking every newborn to what we call comprehensive care. This addresses all the risks that a child would develop,” says Dr Balandya.
“In a proper hospital, a baby would be screened before they are discharged home. It’s also okay to find the ones who might have missed the opportunity. Babies who are brought for immunization for early clinic visits can also be targeted,” he suggested further.
SCD, if detected and diagnosed early, especially if that’s done at a very early stage in newborn children, it has better outcomes in patients with the disease, experts say.
Studies done in the country have shown that Tanzania has one of the highest numbers of annual births of SCD children (11,000), ranking 5th after Nigeria, DRC, India and Angola
Stakeholders are now pushing for advocacy campaigns on the disease. The government has also previously reported to have included SCD as a priority condition in the strategy for management of non-communicable diseases (NCDs).
From the year 2015 to 2016, Muhimbili University of Health and Allied Sciences (Muhas) run a new born screening program for SCD; funded by UKAid through the Human Development Innovation Fund (HDIF).
Through a technique known as isoelectric focusing (IEF), 4,002 newborns were screened at Muhimbili National Hospital (MNH) and Temeke District Hospital.
Findings showed that Thirty one children, (0.8 per cent) with SCD (SS), 504 (12.6 per cent) with sickle cell trait (AS) as well as 27 with other blood disorders (0.7 per cent), and 3,440(85.9 per cent) were SCD negative (AA).
