P114: NEWBORN SCREENING FOR HAEMOGLOBINOPATHIES IN BIDA, NORTH CENTRAL NIGERIA.
Authors: O Folayan, A BELLO, S Ernest
Journal: HemaSphere (2022)

Background: The global annual population of newborns with structural haemoglobin disorders is estimated at five million. Nigeria accounts for more than 30% of these in Sub-Saharan Africa with under-five mortality from haemoglobinopathies reaching 50–90%. Despite this huge burden and a 15-fold reduction in deaths from haemoglobinopathies in countries that conduct newborn screening, most sub-Saharan Africa countries do not have a screening program. Haemoglobin electrophoresis is also not sensitive for newborn screening. Objectives: This study was carried out to determine haemoglobin phenotype patterns and frequency in neonates attending routine immunization clinics in Bida, and to identify factors associated with the occurrence of haemoglobinopathy. Methods: It was a descriptive cross-sectional study that recruited 254 neonates by multi-staged sampling technique from nine immunisation centres. Heel prick blood sample collected on Guthrie cards were tested using High-Performance Liquid Chromatography (HPLC). The relationship of various risk factors with the occurrence of an abnormal haemoglobin variant was analysed with the Statistical Package for Social Sciences. Results: The Hb phenotypes found in this study were HbFA- 73.6% (187/254), HbFAS- 23.2% (59/254), HbFAC- 1.6% (4/254), HbFS- 1.2% (3/254), and HbFAD-0.4% (1/254). There was an almost equal abnormal haemoglobin occurrence in both genders. The majority (89%) of mothers did not know their Hb phenotype, one-quarter of these had a newborn with an abnormal phenotype and 20% married in consanguineous marriages. Wrong perception of sickle cell disease was common. Conclusion: Abnormal haemoglobin variants were present in more than one-quarter (26.4%) of the neonatal population studied in Bida. Most parents were not aware of their haemoglobin phenotype and had a wrong perception of sickle cell disease. Consanguinity though common in the population did not significantly affect the occurrence of an abnormal haemoglobin phenotype. References 1. Hsu L, Nnodu O. E, Brown B. J, Tluway F, King S, Dogara L. G et al. White Paper: Pathways to Progress in Newborn Screening for Sickle Cell Disease in Sub-Saharan Africa. J Trop Dis 2018;6(2):1–9. 2. Weatherall DJ, Clegg J. B. Inherited haemoglobin disorders: An increasing global health problem. Bull World Health Organ 2001;79(8):704–12. 3. Williams T. N, Weatherall D. J. World distribution, population genetics, and health burden of the hemoglobinopathies. Cold Spring Harb Perspect Med 2012;2(116):1–14. 4. Upadhye DS. Neonatal screening & Natural history of sickle cell disease. Immunohaematology Bull 2014;45(2):1–10. 5. Akodu S, Diaku-Akinwumi I, Njokanma O. Age at Diagnosis of Sickle Cell Anaemia in Lagos, Nigeria. Mediterr J Hematol Infect Dis 2013;5(1):1–5. 6. Fleming A. F, Storey J, Molineaux L, Iroko E. A, Attai E. D. Abnormal haemoglobins in the Sudan savanna of Nigeria I. Prevalence of haemoglobins and relationships between sickle cell trait, malaria and survival. Ann Trop Med Parasitol 1979;73(2):161–72 7. Odunvbun, M. E, Okolo A. A, Rahimy CM. Newborn screening for sickle cell disease in a Nigerian hospital. Public Health 2008;122(10):1111–116. 8. Inusa B. P, Daniel Y, Lawson J. O, Dada J, Matthews C. E, Momi S et al. Sickle Cell Disease Screening in Northern Nigeria: The Co-Existence of Β- Thalassemia Inheritance. Pediat Ther 2015;5(3):1–4. 9. Sam-Amoye TO. Prevalence of Sickle Cell Disorder and other Haemoglobinopathies among Newborn Infants Delivered at Government Hospitals in Lagos State. Faculty of Paediatrics. National Postgraduate Medical College. (Unpublished Dissertation). 2017. 10. Ohene-Frempong K, Oduro J, Tetteh H, Nkrumah F. Newborn screening for sickle cell disease in Ghana. Pediatrics 2008;121:120–121.