Awareness, Acceptability and Outcome of Newborn Screening for Sickle Cell Disease in Benue State, Nigeria

Abstract

Background: Sickle cell disease (SCD) is the most common inherited disorder in tropical Africa, and Nigeria, being the most populous African country, contributes about half of the estimated 300,000 newborns with SCD annually. Early identification of SCD through Newborn Screening (NBS) is routine in developed countries, and subsequent delivery of preventive measures and comprehensive care is highly effective in reducing morbidity and early mortality. Despite the proven efficacy of NBS, large-scale implementation in Nigeria is lacking owing to inadequate financial, laboratory, and technical resources. However, inexpensive, easy-to-use tests have been developed that can differentiate common haemoglobin genotypes in newborn babies and can be performed at remote sites.

Objective: To pilot newborn screening in Benue State, Nigeria using SickleScan (BioMedomics, Morrisville, NC, USA).

Methods: This multicenter cross-sectional study involved newborns attending immunisation clinics at three selected facilities in Benue State. Newborns aged 0-6 weeks who presented for immunisation during the study period were screened using the Sicklescan.

Results: A total of 959 newborns were screened over 9 months, with 476 males and 483 females. The distribution of haemoglobin phenotypes showed HbAA 84.4% (n = 810), HbAS 14.1% (n = 135), and HbSS 1.5% (n = 14). The acceptance of NBS was 98.6%, and post-test counselling was performed.

Conclusion: The incidence of sickle cell anaemia among neonates in Benue State, Nigeria, was 1.5%. Newborn screening was widely accepted and can be easily incorporated into immunisation programs for large-scale screening.