Technology will facilitate early diagnosis of sickle cell disease — Study
There is a need for the integration of point-of-care testing technology (POCT) into primary care settings to advance early diagnosis and care of children with sickle cell disease (SCD), particularly in resource-limited regions in the country.
This, according to a study, would help improve patient outcomes and reduce the burden of SCD on affected individuals and their families.
The new study was conducted by the Navrongo Health Research Centre (NHRC) in the Upper East Region.
Titled “Integrating point of care testing (POCT) technology into primary health care setting to advance diagnosis and care of children with sickle cell disease,” it was initiated by the centre in 2022, to determine the percentage of children screened positive for sickle cell disease using a point of care testing device called Gazelle.
The Gazelle device is able to determine the percentages of sickle cell in babies within eight minutes, as compared to standard testing procedures which normally take a longer time to determine.
The study was also intended to evaluate the percentage of SCD-positive children enrolled on comprehensive clinical care.
Rationale
In an interview with the Daily Graphic on the sidelines of a scientific review, a clinical research scientist at the centre, Dr Lucy Osei Ababio, explained that early detection and management of SCD was necessary to prevent childhood deaths and was also relevant to achieving the SDGs.
She said SCD and its variants were genetic disorders resulting from the presence of the mutation of hemoglobin ‘S” (HbS).
Dr Ababio said the highest mortality burden of SCD was concentrated in Sub-Saharan Africa where the total death of individuals with sickle cell disease was about nine times higher than cause-specific deaths of individuals with SCD.
For instance, in 2021, Ghana was declared as one of the countries with SCD of between 1,000 to 2,000 per 100,000 live births.
SCD mortality rates are highest in children under five, and according to the World Health Organisation (WHO), SCD contributes between 9-16 per cent of under-five mortality in certain regions of West Africa, she added.
The study
Dr Ababio said the study employed the use of a point of care device — Gazelle — for SCD screening in 10 health facilities, including four CHPS compounds, five health centres and a hospital, War Memorial Hospital, all located in the Kassena Nankana Municipality and Kassena Nankana West District in the Upper East Region.
She said newborns and children under five years who were presented at their immunisation clinics were screened for SCD with the consent of their parents or guardians.
Nurses and midwives at the various healthcare facilities selected for the exercise also underwent some training.
Dr Ababio said children who tested positive for SCD (SF, SCF, SFA) were referred to a sickle cell clinic the project had set up at the War Memorial Hospital in Navrongo for confirmation and were subsequently admitted.
A total of 6,024 newborns and children under five were screened between August 2022, and September 2023, for the study.
Eighty-one out of the number, representing 1.3 per cent, were confirmed to have SCD.
She said 79 of the 81 confirmed patients, representing 97.5 per cent, were admitted to a comprehensive care unit.
“A confirmatory test was done using a sickle scan device and clients who were confirmed to have SC or SS genotype were enrolled onto the study,” Dr Ababio added.
She said counselling and education on the condition was also offered to the parents and guardians of the babies who tested positive for the SCD.
NHRC
The Navrongo Health Research Centre (NHRC) is one of the three research centres under the Research and Development Division (RDD) of the Ghana Health Service (GHS).
It was established in 1992 to conduct research into major national and international health problems to inform policy and decisions on health.