PREVALENCE OF SICKLE CELL DISORDER AND OTHER HAEMOGLOBINOPATHIES AMONG NEWBORN INFANTS DELIVERED AT GOVERNMENT HOSPITALS IN LAGOS STATE

Abstract

Sickle cell disorders are autosomal recessive disorders in which HbS is inherited alongside
another abnormal haemoglobin variant. They are a major cause of morbidity and mortality in
children. Although sickle cell anaemia is the most common and severe form of sickle cell
disorder in Nigeria, HbSC and Sβ thalassaemia are also seen. Early detection of sickle cell
disorders via newborn screening has emerged as an important public health approach to identify
affected children before they develop complications. Despite having the highest burden of sickle
cell disorders in the world, Nigeria is yet to establish a full scale national neonatal screening
programme and diagnosis is often delayed. Prompt diagnosis and institution of control measures
have been known to reduce morbidity and mortality associated with the disorder.
The aim of the study was to determine the prevalence of sickle cell disorder and other clinically
significant haemoglobin variants among newborn babies in Lagos State and to assess the level of
awareness of sickle cell disorder among their mothers.
The present study was a cross-sectional, observational study carried out in three Government
hospitals in Lagos State, Nigeria. Subjects were recruited over a period of four months (1st of
November 2015 to 28th of February 2016).
A total of 500 babies recruited from consecutive deliveries and their mothers were included in
the study. The Hb genotypes of the babies were determined using High Performance Liquid
Chromatography and awareness of sickle cell disorders among their mothers was assessed using
a structured proforma.
Of the 500 babies, 383(76.6%) were HbAA, 74(14.8%) AS, 16(3.2%) AC and AD respectively,
4(0.8%) Sβ+, 3(0.6%) SC, 2(0.4%) SS, 1(0.2%) AE and 1(0.2%) CC. The overall prevalence of
sickle cell disorder was 1.8%. Majority (78.2%) of mothers knew their Hb genotypes; however,
overall assessment scores for awareness/knowledge about sickle cell disorders among subject’s
mothers were low.
In conclusion, the prevalence of sickle cell disorder among newborn babies in Lagos State is
high at 1.8%. Majority of mothers knew their Hb genotype but lacked in-depth knowledge of
sickle cell disorder. Mothers who were unaware of their Hb genotype or that of their spouse were
more likely to have babies with significant haemoglobinopathies. It is recommended that
screening of all newborn babies should be commenced in order to ensure early detection of
children with sickle cell disorders and allow for prompt institution of prophylactic and long term
control measures. There is also need for more public enlightenment on sickle cell disorders in
order to increase the level of awareness.

PREVALENCE OF SICKLE CELL DISORDER AND OTHER HAEMOGLOBINOPATHIES AMONG NEWBORN INFANTS DELIVERED AT GOVERNMENT HOSPITALS IN LAGOS STATE