Submission ID 117433
| Issue/Objective | Sickle cell disease (SCD) is a significant non-communicable disease (NCD) in sub-Saharan Africa (SSA), causing high morbidity and mortality among newborns. Early detection through newborn screening (NBS) is critical, especially in rural areas like Maryland County, Liberia, to improve survival rates. Since 2017, Partners in Health Liberia (PIHL) and the Ministry of Health (MOH) have implemented the PEN-Plus strategy, integrating NBS for SCD as part of efforts to manage severe NCDs in Liberia. This pilot study evaluates the effectiveness, feasibility, and challenges of NBS as a case-finding strategy in Maryland County |
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| Methodology/Approach | A descriptive pilot study was conducted from March to September 2024, screening 492 newborns across two health facilities. After obtaining informed consent, 5µL of blood was collected via finger prick, heel stick, or venipuncture. The SickleSCAN test kit was used to identify hemoglobin genotypes, and hemoglobin electrophoresis was performed for confirmation. Data on confirmed SCD cases, follow-up, and program challenges were analyzed using RStudio. |
| Results | Out of 492 newborns screened, 5 (1.02%) tested positive for SCD, with an incidence rate of 0.01% (95% CI: 0.13%-1.90%). Additionally, 3 newborns (0.06%) were found to have HbSC, while no cases of sickle cell trait were observed. Females were more affected than males (60% vs. 40%). The case-finding rate was 1.62%, with a 100% follow-up success rate. Challenges included periodic stockouts of kits and delays in sample shipment. However, there was a 100% consent rate and complete linkage to care for affected infants. |
| Discussion/Conclusion | This pilot study demonstrates the feasibility of newborn SCD screening in rural Liberia. Despite challenges, NBS is essential for early case detection within the PEN-Plus framework, with both HbSC and HbSS present in the population. |
| Presenters and affiliations | Ssentamu John Vanglist Partners in Health, Liberia. Lidia S Tefera Partners in Health, Liberia. Bill P. Davis James Jenkins Dossen Hospital Theophilus T. Allison Partners in Health, Liberia. Joe Davies Partners in Health, Liberia. Tomarleen J Collins Partners in Health, Liberia. Arnold ayebare Partners in Health, Liberia. Leroy N. Kpokpah Partners in Health, Liberia. Sterman Toussaint Partners in Health, Liberia. Sarah Anyango Partners in Health, Liberia. C. Peters Maryland County Health Team, Ministry of Health (MOH) Siedoh Freeman Maryland County Health Team, Ministry of Health (MOH) Y.B Freeman Maryland County Health Team, Ministry of Health (MOH) S. Davis Maryland County Health Team, Ministry of Health (MOH) Y.V. Molewoi Maryland County Health Team, Ministry of Health (MOH) Joshua F. Bartue Maryland County Health Team, Ministry of Health (MOH) Alphonso Jallah Partners in Health, Liberia. Howe Wodoblita Partners in Health, Liberia. John Otuba Partners in Health, Liberia. Anthony Tucker The Noncommunicable Diseases Program, MOH Maxo Luma Partners in Health, Liberia. |
