Prevalence of Hemoglobin-S and Baseline Level of Knowledge on Sickle Cell Disease Among Pregnant Women Attending Antenatal Clinics in Dar-Es-Salaam, Tanzania

Abstract

Background: Sickle cell disease (SCD) is the single most important genetic cause of childhood mortality globally. Newborn screening (NBS) is the recommended intervention aimed at early identification of babies with SCD and their linkage to care. To ensure success of NBS, pregnant women need to have the required knowledge on SCD and therefore motivation to screen their babies.Objective: The aim of this study was to determine the prevalence of hemoglobin-S and assess the baseline level of knowledge on SCD among pregnant women attending antenatal clinics in urban settings in Dar-es-Salaam, Tanzania.Methods: This cross-sectional study was conducted between August 2020 and February 2021, involving 600 pregnant women at 20–28 weeks of gestation attending antenatal clinics at Buguruni Health Center, Mbagala Hospital, and Sinza Hospital in Dar-es-Salaam, Tanzania. We administered a structured questionnaire to all participants to assess socio-demographic characteristics and baseline level of knowledge on SCD, where those scoring 7 or higher out of 10 questions were considered to have good knowledge. We screened for SCD a total of 300 participants from two centers (Buguruni Health Center and Mbagala Hospital) by using Sickle SCAN point-of-care test (BioMedomics Inc., United States). We used SPSS version 23 to analyze the data. On determining the association between level of knowledge and socio-demographic factors, we used Pearson’s Chi-square and multivariate logistic regression in ascertaining the strength of associations.Results: Of the 600 participants, the majority were of the age between 26 and 35 years (51%), with the parity of 1-3 children (55.8%) and secondary level of education (43%), while 56% were self-employed. Only 14.7% had good knowledge on SCD. The majority of the participants had ever heard of SCD (81.3%), most of them heard from the streets (42.4%), and only 2.4% heard from hospitals. Of all 600 study participants, only 2 (0.3%) knew their SCD status while 7.7% declared having a family history of SCD. A proficient level of knowledge on SCD is associated with a high level of education, occupation, and knowing personal status of SCD. Among 300 participants who were screened for SCD, 252 were Hb-AA (84%), 47 were Hb-AS (15.7%), and 1 (0.3%) was Hb-SS.Conclusion: Despite the high prevalence of hemoglobin-S among pregnant women attending antenatal clinics in urban settings in Tanzania, there is a poor level of knowledge on SCD and personal knowledge of SCD status. Maternal screening and health education on SCD should be included as part of the comprehensive package for health promotion at antenatal clinics.

Predictors of the Effectiveness of Health Education Intervention and Infant Diagnosis for Sickle Cell Disease Among Pregnant Women Attending Antenatal Clinics in Dar-es-salaam, Tanzania: a Quasi Experimental Study

“…Despite the high prevalence of SCD in Tanzania (13-20%) (3,4), only 2 participants knew their SCD status before intervention (11). This was quiet similar to many other studies which showed low awareness of personal SCD status among different groups (8, 9, 11, 13).…”

The efficacy of maternal health education and maternal screening on knowledge and the uptake of infant screening for sickle cell disease in Dar-Es-Salaam, Tanzania; a quasi experimental study

“…The ANCs have been successfully utilized in providing health education on HIV and other conditions [ 16 – 19 ], and thus success in proving health education on SCD opens the possibility to consider integrating health education on SCD into the comprehensive care package for pregnant women [ 10 ], particularly in areas with high prevalence of SCD. Before health education intervention, the level of knowledge among pregnant women in our cohort was significantly predicted by the level of education, hearing of SCD at school and having lived with a patient with SCD [ 20 ]. However, following health education intervention, the efficacy of the intervention was only predicted by having shared the received information with others.…”

Communicating sickle cell trait results after newborn screening: Approaches and implications to families

“…Results from this study has shown that families understanding of the results provided is still challenging. This observation suggests that despite the high birth prevalence of SCD in the area, still knowledge on the disease is very low (Abioye-Kuteyi et al, 2009;Ezenwosu et al, 2015;Obed et al, 2017;Tutuba et al, 2022). One of the recommendations to address this is to increase public awareness through cultural respectful advocacy campaigns within the communities (Anie et al, 2016;Brown, 2012).…”

“…This will ensure mothers receive adequate education on the SCD and SCT and do understand implications of having a child with either of the two. Others suggested to start providing the health education programs during antenatal clinics where uptake/ attendance is very good and great possibility of finding both parents (Tutuba et al, 2022). Others have suggested counselling and education programs to be offered soon after screening (Ojodu, 2014).…”