Sickle cell disease in Africa: an overview of the integrated approach to health, research, education and advocacy in Tanzania, 2004–2016

Tluway, Furahini; Makani, Julie

doi:10.1111/bjh.14594

Cited by 70 publications

(78 citation statements)

References 34 publications

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“…is clearly supports reports of the United Nations General Assembly which recognized SCD as a global public health concern due to its high morbidity and mortality as well as the significant social and economic impact that results from the disease [14]. SCD patients in the developed world account for only 10% of the world's SCD patient population [11].…”

Section: Introductionsupporting

confidence: 81%

Assessment of Hemoglobin Variants in Patients Receiving Health Care at the Ho Teaching Hospital: A Three-Year Retrospective Study

Awaitey

Akorsu

Allotey

et al. 2020

Advances in Hematology

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Background. It is estimated that one out of every three Ghanaians has hemoglobin genotype mutation. This change in genetic make-up may result in genotypes such as HbAS, HbSS, and HbSC. Many children in low- and middle-income countries die even before they are diagnosed with sickle cell disease (SCD). In Africa, there are limited data on the incidence and prevalence of SCD and the Volta region of Ghana is no exception. Aim. The aim of this study was to determine the prevalence of SCD and to assess the hemoglobin variants among patients attending Ho Teaching Hospital. Methods. A retrospective study design was used to extract information from the Hospital Administration and Management Systems (HAMS) on the hemoglobin electrophoresis results and corresponding full blood count results of the SCD and sickle cell anemia (SCA) patients as well as patients who were asked to do Hb electrophoresis irrespective of their sickling status. Data were collected for the period January 2016 to December 2018. Sickle cell disease status was determined using the Hb genotypes from the Hb electrophoresis results. The full blood count was used to categorize the severity of anemia based on the hemoglobin concentration in the SCA and SCD patients. Results. A total of 1,523 subjects were included in the study of which the prevalence for sickle cell disease was 16.7%. The SCD genotypes included HbS (6.2%), HbSC (7.9%), and HbSF (2.6%). Hemoglobin C disease (HbCC) constituted 0.3% out of the total prevalence of SCD. The prevalence of anemia was 99.2%, with the severest form in HbS. Also, majority of the SCD patients had severe anemia. Difference in the severity of anemia was found to be significant among both male (P=0.006) and female (P=0.004) participants with SCD. Conclusion. Patients receiving health care at the Ho Teaching Hospital had different hemoglobin variants with HbAS recording the highest prevalence. The high incidence of hemoglobin AS implies the possibility of having an increased population of individuals with sickle cell disease in future if measures are not put in place to improve screening, counseling, and education of the public about the health threat SCD poses.

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Section: Introductionsupporting

confidence: 81%

Assessment of Hemoglobin Variants in Patients Receiving Health Care at the Ho Teaching Hospital: A Three-Year Retrospective Study

Awaitey

Akorsu

Allotey

et al. 2020

Advances in Hematology

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“…In high‐income countries, the life expectancy of patients with SCD is estimated to be more than 50 years, whereas in sub‐Saharan Africa many affected children die before reaching adulthood (Modell & Darlison, ). However, the survival of African patients with SCD is progressively increasing due to improved access to health care (Akinyanju et al , ; Modell & Darlison, ; Tluway & Makani, ). An increasing number of children and teenagers will, therefore, be at risk of both acute vaso‐occlusive complications and chronic organ damage.…”

mentioning

confidence: 99%

Prevalence and correlates of growth failure in young African patients with sickle cell disease

et al. 2018

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Summary Growth failure (GF) in children with sickle cell disease (SCD) tends to decline in high‐income countries, but data are lacking in sub‐Saharan Africa. We performed a cross‐sectional study nested in the CADRE (Cœur, Artères et DREpanocytose) cohort in Mali, Senegal, Cameroon, Gabon and the Ivory Coast. SCD patients and healthy controls aged 5–21 years old were recruited (n = 2583). Frequency of GF, defined as a height, weight or body mass index below the 5th percentile on World health Organization growth charts, was calculated. We assessed associations between GF and SCD phenotypic group, clinical and biological characteristics and history of SCD‐related complications. GF was diagnosed in 51% of HbSS, 58% of HbSβ0, 44% of HbSC, 38% of HbSβ+ patients and 32% of controls. GF in patients was positively associated with parents’ lower education level, male sex, age 12–14 years, lower blood pressure, HbSS or HbSβ0 phenotypes, icterus, lower haemoglobin level, higher leucocyte count and microalbuminuria. No association was found between GF and clinical SCD‐related complications. In sub‐Saharan Africa, GF is still frequent in children with SCD, especially in males and during adolescence. GF is associated with haemolysis and microalbuminuria, but not with the history of SCD‐related clinical complications.

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“…The sickle cell clinical and research project was already underway and has developed further since 2005. The cumulative number of individuals enrolled has increased from 400 in 2005 to 4000 in 2015 (described in more detail in this issue (Tluway & Makani, 2017). …”

Section: A New Post-graduate Training Course In Haematology and Bloodmentioning

confidence: 99%

Strengthening medical education in haematology and blood transfusion: postgraduate programmes in Tanzania

et al. 2017

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Summary Haematology and blood transfusion, as a clinical and laboratory discipline, has a far-reaching impact on healthcare both through direct patient care as well as provision of laboratory and transfusion services. Improvement of haematology and blood transfusion may therefore be significant in achieving advances in health in Africa. In 2005, Tanzania had one of the lowest distributions of doctors in the world, estimated at 2·3 doctors per 100 000 of population, with only one haematologist, a medical doctor with postgraduate medical education in haematology and blood transfusion. Here, we describe the establishment and impact of a postgraduate programme centred on Master of Medicine and Master of Science programmes to build the capacity of postgraduate training in haematology and blood transfusion. The programme was delivered through Muhimbili University of Health and Allied Sciences (MUHAS) with partnership from visiting medical and laboratory staff from the UK and complemented by short-term visits of trainees from Tanzania to Haematology Departments in the UK. The programme had a significant impact on the development of human resources in haematology and blood transfusion, successfully training 17 specialists with a significant influence on delivery of health services and research. This experience shows how a self-sustaining, specialist medical education programme can be developed at low cost within Lower and Middle Income Countries (LMICs) to rapidly enhance delivery of capacity to provide specialist services.

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Sickle cell disease in Africa: an overview of the integrated approach to health, research, education and advocacy in Tanzania, 2004–2016

Cited by 70 publications

References 34 publications

Assessment of Hemoglobin Variants in Patients Receiving Health Care at the Ho Teaching Hospital: A Three-Year Retrospective Study

Assessment of Hemoglobin Variants in Patients Receiving Health Care at the Ho Teaching Hospital: A Three-Year Retrospective Study

Prevalence and correlates of growth failure in young African patients with sickle cell disease

Strengthening medical education in haematology and blood transfusion: postgraduate programmes in Tanzania

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