Sickle cell disease (SCD) is a genetic disease that affects the red blood cells. It is a serious and lifelong health condition and is a common cause of childhood mortality across Africa. Tanzania ranks fifth in the world for the highest number of SCD births annually and it is estimated that the disease accounts for 6.6 per cent of all deaths of children under the age of five each year. Yet deaths from the disease are not inevitable. Early identification of SCD through newborn screening (NBS) means that symptoms can be treated and managed promptly, increasing the chances of survival for children with the illness.
The Newborn Screening for Sickle Cell Disease programme was an innovative health intervention that previously had not been implemented in Tanzania. In addition to increasing the survival rates of children diagnosed with SDC, the pilot also aimed to improve the quality of reproductive and child health (RCH) services by training health workers on NBS theory and practice. The pilot was implemented as a routine RCH service in two public hospitals, Muhimbili National Hospital (MNH) and Temeke Hospital. A blood sample was taken from a newborn baby within 48 hours of birth and screened for the disease. Babies who were found to be SCD positive were then given appropriate follow-on care while health-care workers educated parents about the disease, including its symptoms and treatments. Pregnant women were also made aware of SDC during their regular antenatal clinic visits.
Between September 2015 and August 2016, the NBS programme screened 4,002 newborns (12 months): 1,142 (29 per cent) at MNH and 2,839 (71 per cent) at Temeke Hospital. As a result:
- 31 newborns were diagnosed with SCD, 508 were identified as carriers of the SCD gene, 27 were diagnosed with other haematological disorders, and 3,436 were found to be SCD negative. All 31 babies who were diagnosed with SCD at birth were given comprehensive care.
- 160 nurses from MNH, Temeke, Amana, and Mwananyamala Hospitals and eight laboratory technicians were trained on SCD screening using
Isoelectric Focusing (IEF) and High Performance Liquid Chromatography (HPLC) methods.