NEONATAL SCREENING FOR SICKLE CELL DISEASE IN KANO, NORTH-WEST NIGERIA

Abstract

Background: Sickle Cell Disease is the most common, life-threatening, single-gene disorder
in the world. Neonatal screening for Sickle Cell Disease enables early diagnosis and
institution of proactive management to reduce the development of complications. Studies in
different parts of the world have established that neonatal screening for Sickle Cell Disease
has drastically reduced infant mortality and morbidity.
Aim and objectives: This study was conducted to determine the incidence of homozygous
and heterozygous Sickle Cell Disease, the incidence of the sickle cell trait, and some
haematological parameters in them.
Methodology: This was a hospital-based, prospective, cross-sectional study. Consecutive
sampling on the basis of time was the method employed. Three hundred and thirty neonates
aged 1 to 3 days were enrolled into the study. Socio-demographic data of the neonate and
parents were collected using an interviewer administered questionnaire. Following a signed
informed consent from the parent or guardian of the neonate, capillary blood was obtained
via heel prick and a sample of 0.3ml blood was obtained in an EDTA micro-container for
complete blood count, followed by dried blood spot samples stored in a glassine envelope at
4°C, and later analysed for hemoglobin variants using High Performance Liquid
Chromatography.
Results: Incidence of Hb A was found to be 77.6%; Hb AS was 20.3%, Hb SS was 1.8%,
and Hb AC was 0.3%. No heterozygous form of sickle cell disease was observed. There was
no statistically significant difference in the haematological parameters across the various Hb
phenotypic groups, Mean HbF = 71.06 ± 8.75%; HbA2= 0.85± 0.32%; Hb concentration=
15.74 ± 0.62g/dL; Hct = 46.95 ± 1.79%; RCC = 4.52 ± 0.21 X 1012/L; MCV = 103.84 ±
2.26fL; MCH =34.82 ± 0.81pg; MCHC =33.58 ± 0.26g/dL; RDW = 18.56 ± 0.52%,
TWCC=11.70± 0.57 X 106/L; Gran = 6.52 ± 0.54 X 106/L; Mid=0.80 ± 0.07 X 106/L; Lym =
4.39 ± 0.46 X 106/L; PLT =292.45 ± 32.79 X 106/L.
Conclusion: Hb A is the predominant haemoglobin variant among neonates in Kano. The
incidence of Sickle Cell Disease in Northwest Nigeria has not changed significantly over the
past four decades. Haemoglobin C is rare in Northern Nigeria.

NEONATAL SCREENING FOR SICKLE CELL DISEASE IN KANO, NORTH-WEST NIGERIA