Establishing care for sickle cell disease in western Kenya: achievements and challenges

Wanjiku, Christopher Mwaniki; Njuguna, Festus; Asirwa, Fredrick Chite; Mbunya, Samuel; Githinji, Cyrus; Roberson, Chris; Greist, Anne

doi:10.1182/bloodadvances.2019gs121620

Cited by 7 publications

(5 citation statements)

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“…The overall positivity rate in our study of all the sickle cell screening tests namely; sickling test, Hemo type SC and HB electrophoresis was 39.32% which is way far ahead of the recorded regional prevalence of 4.5% of children born with homozygous disease and 18% of those born with sickle cell trait [8]. This difference can be attributed to the fact that a criterion of inclusion into the…”

Section: Discussionmentioning

confidence: 58%

“…Clinical judgment is important in SCD diagnosis and this method of management and diagnosis has been used in other studies globally[9].Another reason could be due to the fact that there might have been false positive cases by the use of sickling test[10]. Our study included participants of all ages as opposed to Wanjiku et al study that focused on new born and only relied on HB electrophoresis for screening and diagnosis[8].Among those screened by Hemo type SC, the prevalence of hemoglobin S was at 49.1% which was higher than 15% found in a Côte d'Ivoire study which analyzed 236 children of all-comers[11]. The diagnostic sensitivity, specificity and test efficiency of Hemo type SC for sickle cell disease (Hb SS and Hb SC), were 100.0, 98.2 and 98.2%, respectively[5].…”

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confidence: 99%

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Analysis of Provider Initiated Sickle Cell Disease Screening in Mathare Slums, Nairobi Kenya: A Case of German Doctors, Baraka Health Centre

Omoto,

Mumbo,

Hussein

et al. 2023

JAMMR

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Sickle cell disease (SCD) results in alteration of both hematological and biochemical parameters of the affected individuals. In Kenya, it is estimated that 4,000 children are born with SCD annually; about 21% of children in Kisumu are born with Sickle cell trait. Study objective was to analyze the screening of SCD using various screening techniques at German Doctors-Baraka Health Center in Mathare, Nairobi. On methodology, purposive sampling and cross sectional study design was employed among patients of all ages with clinical features suggestive of SCD. Data utilization permission was sought from hospital administration. Patients’ January 2019 to May 2023 secondary data was extracted from the hospital’s medical records and analyzed using SPSS version 21, the results were presented in percentages. The study found; comprehensive diagnostic approach of SCD facilitated screening of 2053 subjects. About 512 patients were screened by conventional “sickling test” using sodium metabisulphite, 791 by Sickle Cell Scan and 750 by electrophoresis method. Generally, among 2053 subjects screened, the positivity rate was 48.2%. Sickling test positivity rate was 45.9% and 49.1% positivity for Sickle Cell Scan. Sickle Cell Scan screened 791 (49.1%) subjects, and 39.32% of the 791 had homozygous while 9.73% of the 791 were heterozygous forms. Electrophoresis identified forms of sickle cell; with homozygous and heterozygous representing 38.8% and 10% respectively. It concludes that reliability of Sickle Cell Scan and HB electrophoresis are relatively the same based on almost similar rates in identifying true positive cases and the forms of sickle cell disease. The study recommends that clinicians capacity building on managing SCD is required.

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Section: Discussionmentioning

confidence: 58%

mentioning

confidence: 99%

Analysis of Provider Initiated Sickle Cell Disease Screening in Mathare Slums, Nairobi Kenya: A Case of German Doctors, Baraka Health Centre

Omoto,

Mumbo,

Hussein

et al. 2023

JAMMR

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“…This region also has high morbidity and mortality rates due to infectious diseases such as malaria, HIV-1, and eBL [ 6 , 27 ]. The SCT prevalence is 16.2%, and about 40% of children are heterozygous for α-thalassemia [ 9 , 28 ]. Perennial P. falciparum is responsible for ~ 97% of malarial infections, resulting in high childhood mortality rates [ 27 ].…”

Section: Methodsmentioning

confidence: 99%

Hemoglobinopathies, merozoite surface protein-2 gene polymorphisms, and acquisition of Epstein Barr virus among infants in Western Kenya

et al. 2023

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Background Epstein Barr virus (EBV)-associated endemic Burkitt’s Lymphoma pediatric cancer is associated with morbidity and mortality among children resident in holoendemic Plasmodium falciparum regions in western Kenya. P. falciparum exerts strong selection pressure on sickle cell trait (SCT), alpha thalassemia (-α3.7/αα), glucose-6-phosphate dehydrogenase (G6PD), and merozoite surface protein 2 (MSP-2) variants (FC27, 3D7) that confer reduced malarial disease severity. The current study tested the hypothesis that SCT, (-α3.7/αα), G6PD mutation and (MSP-2) variants (FC27, 3D7) are associated with an early age of EBV acquisition. Methods Data on infant EBV infection status (< 6 and ≥ 6–12 months of age) was abstracted from a previous longitudinal study. Archived infant DNA (n = 81) and mothers DNA (n = 70) samples were used for genotyping hemoglobinopathies and MSP-2. The presence of MSP-2 genotypes in maternal DNA samples was used to indicate infant in-utero malarial exposure. Genetic variants were determined by TaqMan assays or standard PCR. Group differences were determined by Chi-square or Fisher’s analysis. Bivariate regression modeling was used to determine the relationship between the carriage of genetic variants and EBV acquisition. Results EBV acquisition for infants < 6 months was not associated with -α3.7/αα (OR = 1.824, P = 0.354), SCT (OR = 0.897, P = 0.881), or G6PD [Viangchan (871G > A)/Chinese (1024 C > T) (OR = 2.614, P = 0.212)] and [Union (1360 C > T)/Kaiping (1388G > A) (OR = 0.321, P = 0.295)]. There was no relationship between EBV acquisition and in-utero exposure to either FC27 (OR = 0.922, P = 0.914) or 3D7 (OR = 0.933, P = 0.921). In addition, EBV acquisition in infants ≥ 6–12 months also showed no association with -α3.7/αα (OR = 0.681, P = 0.442), SCT (OR = 0.513, P = 0.305), G6PD [(Viangchan (871G > A)/Chinese (1024 C > T) (OR = 0.640, P = 0.677)], [Mahidol (487G > A)/Coimbra (592 C > T) (OR = 0.948, P = 0.940)], [(Union (1360 C > T)/Kaiping (1388G > A) (OR = 1.221, P = 0.768)], African A (OR = 0.278, P = 0.257)], or in utero exposure to either FC27 (OR = 0.780, P = 0.662) or 3D7 (OR = 0.549, P = 0.241). Conclusion Although hemoglobinopathies (-α3.7/αα, SCT, and G6PD mutations) and in-utero exposure to MSP-2 were not associated with EBV acquisition in infants 0–12 months, novel G6PD variants were discovered in the population from western Kenya. To establish that the known and novel hemoglobinopathies, and in utero MSP-2 exposure do not confer susceptibility to EBV, future studies with larger sample sizes from multiple sites adopting genome-wide analysis are required.

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“…Gabon has an estimated SCD prevalence rate of 1.8% ( Minto’o et al ., 2022 ) and Cameroon has an estimated prevalence rate of 0.6% ( Alima Yanda et al ., 2017 ). There is no national prevalence documentation of SCD in Tanzania, however an estimate of about 11,000 births annually has been recorded ( Makani et al , 2018 ) Western parts of Kenya have an estimated 4.5% of children born with SCD, and 18% of children born with sickle cell trait ( Wanjiku et al ., 2019 ). Angola, DRC, and Gabon could not be included in the analysis due to insufficient GT data.…”

Section: Methodsmentioning

confidence: 99%

Impact of Sickle Cell Awareness Day on online health information seeking in Africa using Google Trends

Parry,

Ayinla-Jimoh,

Shepherd

2023

Health Promotion International

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The United Nations Council Assembly recognized sickle cell disease (SCD) as a global public health problem due to its increasing burden, particularly in sub-Saharan Africa. To raise awareness, a resolution was adopted, designating June 19th as SCD awareness day. However, the impact of this awareness day on online health information seeking behaviour (OHISB) in African countries is not well understood, especially in Nigeria, Ghana and Uganda where SCD prevalence is high. To assess the impact, the study used Google Trends data as a measure of OHISB for SCD. The analysis covered the 60 days before the awareness day, the awareness day itself, and the 60 days afterward. Time series analysis was conducted using joinpoint regression to identify significant changes in OHISB trends. The results indicated that the impact of the Sickle Cell Awareness Day on OHISB varied across African countries and did not consistently inspire significant changes in information seeking behaviour. This suggests the need for more targeted awareness campaigns to improve public knowledge of SCD in Africa. It also highlights the importance of revising the current awareness day or creating alternative health awareness initiatives that adopt a long-term approach and address the specific health needs of the African population. Furthermore, due to limitations in using Google Trends data in some African countries with insufficient data, future research should explore other sources of internet data or conduct surveys to gain a more comprehensive understanding of the impact of the Sickle Cell Awareness Day on OHISB in Africa.

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Establishing care for sickle cell disease in western Kenya: achievements and challenges

Cited by 7 publications

References 0 publications

Analysis of Provider Initiated Sickle Cell Disease Screening in Mathare Slums, Nairobi Kenya: A Case of German Doctors, Baraka Health Centre

Analysis of Provider Initiated Sickle Cell Disease Screening in Mathare Slums, Nairobi Kenya: A Case of German Doctors, Baraka Health Centre

Hemoglobinopathies, merozoite surface protein-2 gene polymorphisms, and acquisition of Epstein Barr virus among infants in Western Kenya

Impact of Sickle Cell Awareness Day on online health information seeking in Africa using Google Trends

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