Newborn screening for sickle cell disease at Kisumu County Hospital, Kisumu –Kenya

Abstract

Background: Sickle cell disease(SCD), a hereditary blood disorder of the haemoglobin molecule, has been acknowledged by World Health Organization(WHO) as a major public health priority. Newborn screening(NBS) for SCD coupled with provision of comprehensive medical care has been associated with a significant reduction in related morbidity and mortality.
Objectives: To estimate the birth prevalence of Sickle Cell Disease (SCD) and trait (SCT), assess acceptability of NBS and determine factors that influence acceptability of NBS at Kisumu County Hospital(KCH), Kenya during the period between November 2015 to June 2016.
Design: Cross Sectional Study
Setting: The postnatal ward at the KCH which serves a population of about one million people with about 300 deliveries occuring every month.
Results: Data was collected from 1785 parents/guardians and 1810 new-borns (23 sets of twins and one set of triplets). There were 921 (50.9%) male new-borns. The parents/guardians were aged between 18 and 42 years (median 23 years), 11(0.6%) had no formal education, 1129 (63.2%) had heard about SCD but only 14(1.2 %) had ever been tested for SCD. Birth prevalence of SCD and SCT among the new-borns was 57(3.2%) and 250(13.9%) respectively. Almost all parents/caregivers, 1774(99.4%) accepted to have their new-borns screened. Among those who declined, 8 cited fear of the unknown as the main reason. All the parents/guardians who had no formal education and all those who had ever been tested for SCD before accepted NBS. Agreeing that SCD is preventable was the only statistically significant factor on bivariate and multivariate logistic regression analysis (OR 4.68, CI (1.15-19.17), P =0.014).
Conclusion: NBS for SCD was highly acceptable. The birth prevalence of sickle cell disease and trait was high according to the WHO.
Recommendations: Implementation of routine NBS for SCD in Kisumu County and other high SCD prevalence regions in Kenya.