Project Details

Universal Screening for Sickle Cell Disease in Homa Bay County: A Pilot Program in Western Kenya

Mary Ann Etling, MD, MPH

Summary

BACKGROUND: Sickle cell disease (SCD) is an inherited, life-threatening blood disorder affecting >500,000 infants globally each year, the majority living in sub-Saharan Africa. Without access to early diagnosis and treatment, most of these children will die before five years of age. GAP: Most studies of screening and treatment for SCD in Africa are centralized at a tertiary care center, where diagnosis and treatment occur. The burden of SCD in Africa is too high for a centralized approach. There have been no studies linking early diagnosis with local clinical care using a decentralized strategy as we propose in Homa Bay, Kenya. HYPOTHESIS: We hypothesize that we will screen >50% of all infants born across Homa Bay County with more screening taking place at vaccination centers than maternity facilities and that >90% of infants diagnosed with SCD will be linked to SCD care at their local health facility. METHODS: In partnership with Homa Bay County Health, we are conducting a county-wide, decentralized comprehensive screening and treatment program for SCD. This study aims to screen ~10,000 newborns and infants performed across the ten sub-counties of Homa Bay County in maternity facilities and vaccination centers over a one-year period. Infants who screen positive for SCD will be referred for treatment at the newly established SCD clinics at each of the 9 subcounty health facilities. RESULTS: Screening is currently ongoing. IMPACT: This study is situated within the first publicly embraced and implemented comprehensive sickle cell screening and treatment program in Homa Bay, Kenya. Most importantly, affected infants will be referred for prompt initiation of treatment for SCD at their local health facility, which will expand capacity to provide care for SCD without requiring centralized SCD care centers. By geographically describing the burden of SCD and sickle cell trait in Homa Bay, we will be able to better characterize the need for allocation of SCD resources and will provide further opportunities for SCD research in this high burden region of Kenya.