When Did Newborn Screening For Sickle Cell Start

Can Anyone Have A Test For Sickle Cell And Thalassaemia

Testing gene editing for sickle cell disease – Stanford Children’s Health

Although testing for sickle cell and thalassaemia is only offered during pregnancy, anyone can ask their GP or local sickle cell and thalassaemia centre for a free test at any time.

If you or your partner are concerned you may be a carrier, perhaps because someone in your family has a blood disorder or is a carrier, it’s a good idea to get tested before you start a family.

That way you can understand your risk of passing on a blood disorder to any children you have, and discuss options for a healthy pregnancy with your GP or another healthcare professional.

What Are The Symptoms Of Scd

SCD causes minimal effects in some people and more serious problems in others. While SCD can cause many symptoms, most people with SCD do not develop all of the symptoms. Symptoms can be chronicAny condition that lasts for a long period of time or occurs frequently. For example, diabetes and hemochromatosis are both chronic conditions. or acute . It is important to be educated about the symptoms so that they can be properly managed.

The symptoms of SCD are related to anemia, pain, or the effects of SCD on specific body parts.

Most infants do not show signs of SCD until they are a few months old. Often, the first sign of SCD is pain or swelling in the childs hands or feet when small blood vessels become blocked. This causes some children to develop a fever.

Signs of anemia include:

  • Chest pain

Pain episodes

Symptoms caused by blocked blood vessels

Spleen problems The spleen is an organ that removes damaged red blood cells and fights infection. Sickle cells can clog the spleen. This not only weakens the spleens ability to fight infections but can cause pain on the left side of the abdomen.

Lung problems Blocked blood vessels in the lungs cause symptoms such as wheezing, difficulty breathing, chest pain, and fever. This is called acute chest syndromeA group of symptoms and clinical findings that, when found together, make up a particular condition or disease.. Children with these symptoms often require hospitalization.

Other symptoms

Protocol And Methodological Approach

The review formed part of a health technology assessment conducted by the German Institute for Quality and Efficiency in Health Care . The full report and protocol are available on the Institutes website . IQWiGs responsibilities and methodological approach are described in its methods paper . This review was written according to the PRISMA statement . Only previously published studies were used, so an ethical review and patient consent were not required.

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Newborn Screening And Definitivediagnosis

In Illinois, newborn screening for sickle cell disease is performed by high performance liquid chromatography testing to determine the presence of abnormal hemoglobins in whole blood. Unaffected infants will have mostly fetal hemoglobin and some adult hemoglobin . HPLC has been shown effective in detecting hemoglobinopathies characterized by synthesis of an abnormal hemoglobin molecule immediately after birth. A baby testing positive for a form of sickle cell disease will have Hgb F with Hgb S and possibly, another abnormal hemoglobin such as Hgb C, Hgb E or beta thalassemia. All abnormal newborn screening test results indicating a sickle cell disorder require appropriate confirmatory blood tests, sometimes including testing of parents and siblings for actual diagnosis. Referral to a pediatric hematologist for evaluation and diagnostic testing is recommended within the first month of life and should not be delayed until the infant is older.If newborn screening results indicate less serious hemoglobin disorders or traits, referral to a pediatric hematologist for parental education and counseling is recommended. Even small transfusions may cause false negative screening test results and any results indicating that the baby was transfused require repeat testing 90 days after the last transfusion.

Search Strategy And Study Selection

Improving newborn sickle cell screening in Africa: We can ...

We searched for relevant primary studies and secondary publications in MEDLINE via PubMed and via Ovid , EMBASE , and the Cochrane Central Register of Controlled Trials as well as trial registries . The Cochrane Database of Systematic Reviews , MEDLINE, EMBASE, and the Health Technology Assessment Database were searched for relevant systematic reviews. Reference lists of relevant systematic reviews were screened for additional relevant primary studies. There were no restrictions on language or date of publication. Conference abstracts were not eligible for inclusion. The search strategies, which were developed by one information specialist and checked by another, are presented in Additional file . After conducting the search, duplicates were removed using the reference management software Endnote X9 . The remaining references were then screened with the in-house web trial selection database .

Two reviewers independently screened titles and abstracts of the citations retrieved to identify potentially eligible primary and secondary publications. The full texts of these articles were obtained and independently evaluated by the same two reviewers applying the full set of inclusion and exclusion criteria. Disagreements were resolved by consensus.

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Pregnant Women With Sickle Cell Disease

Women living with SCD who become pregnant often face extreme discrimination and discouragement in Uganda. These women are frequently branded by their peers as irresponsible for having a baby while living with sickle cell disease or even engaging in sex while living with SCD. The criticism and judgement these women receive, not only from healthcare professionals but also from their families, often leaves them feeling alone, depressed, anxious, ashamed, and with very little social support. Most pregnant women with SCD also go on to be single mothers as it is common for them to be left by their male partners who claim they were unaware of their partner’s SCD status. Not only does the abandonment experienced by these women cause emotional distress for them, but this low level of parental support can be linked to depressive symptoms and overall lower quality of life for the child once they are born.

What Is Ss Disease

S,S disease is an inherited condition that affects the hemoglobin in blood. Hemoglobin is a part of your red blood cells, which carry oxygen in your body. In S,S disease, normal hemoglobin is replaced with hemoglobin S, which is also called sickle hemoglobin.

S,S disease is a form of sickle cell disease. Normal blood cells are round and shaped like doughnuts. Babies with S,S disease have red blood cells that sickle or become crescent moon-shaped. The sickle shape of red blood cells in babies with S,S disease means the red blood cells have a harder time bringing oxygen to the body. Sickle cells also break down more quickly and can get stuck in the blood vessels. This causes many signs and symptoms of the condition.

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What Is Sickle Cell Disease

SCD is an inherited blood disorder that results in chronic health problems. People with SCD have abnormal hemoglobin. Hemoglobin is the protein in red blood cells that carries oxygen from the lungs to the rest of the body. Abnormal, or sickle-shaped, hemoglobin cannot deliver enough oxygen to the rest of the body. This causes individuals with SCD to experience episodes of pain. Over time, lack of oxygen damages the organs, especially the spleenThis is an organ located behind the stomach. It gets rid of old blood cells and helps fight infection. The spleen can enlarge in people with cirrhosis or with certain metabolic disorders., brain, lungs, and kidneys. SCD also causes anemiaThis is a condition in which the blood has too few red blood cells or too little hemoglobin, the oxygen carrying molecule in the blood. People with anemia are often pale, tired, weak, dizzy and short of breath., or a low number of red blood cellsRed blood cells are the major component in blood that delivers oxygen from the lungs to the body tissues..

There are several types of SCD, including hemoglobin SS, hemoglobin SC, and hemoglobin S-beta thalassemia. The most common type of SCD is hemoglobin SS. The different types of SCD have some symptoms in common and some symptoms that are unique to each different type of SCD. It is important to find out which type of SCD your child has and talk with your doctor about signs, symptoms, and treatment specific to that condition.

We’ve Helped Thousands Of Babies During 10 Years Of Newborn Screening For Sickle Cell Disease

What is Sickle Cell Anemia?

This year marks the 10th anniversary of the full roll-out of newborn screening for sickle cell disease in England.

Weve screened nearly 7 million newborn babies for SCD between 2006 and 2016.

Babies are screened for SCD as part of the newborn blood spot screening test, also known as the heel-prick test. Of the 7 million screened, just over 3,200 have screened positive.

Despite detection of thalassaemia not being part of the programme, we do expect beta thalassaemia major to be detected and reported. In the past 10 years, nearly 250 cases of beta thalassaemia major have been identified .

SCD is the name for a group of related conditions that affect the quality of haemoglobin and the capacity to carry oxygen around the body. The most serious form of the disease is sickle cell anaemia.

Screening for sickle cell disease in newborn babies identifies infants affected by the condition, with the aim of minimising childhood morbidity. Children with the condition are at risk of severe illness or even death from infections. Early identification of the condition allows treatment to begin promptly.

The introduction of the NHS Sickle Cell and Thalassaemia Screening Programme in England has also been the major driving force for improvements both in awareness and in the quality of care for children and families with sickle cell and other major haemoglobinopathies.

Gone are the days when a new mother would give birth to a child with sickle cell and ask whats that?

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Sickle Cell Disease Screening: Why Its Necessary

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Although known in parts of Africa for hundreds of years by various names, the first medical mention of sickle cell disease came in 1910. A Chicago physician named James B. Herrick described a patient from the West Indies with anemia and sickle shaped red blood cells.

Knowledge of the disease, a group of inherited blood disorders, grew from there, especially after the passage of the Sickle Cell Anemia Control Act in 1972.

The National Institutes of Health recommended all newborns be screened for sickle cell disease in the late 1980s. It took until 2006 to be mandated in all 50 states and Washington D.C.

Pennsylvania began formal screening for sickle cell disease and other hemoglobin abnormalities in newborns in 1992.

Newborn screening is an important and potentially life-saving measure.

Testing For Sickle Cell Carriers

A blood test can be done at any time to find out if you carry sickle cell and are at risk of having a child with sickle cell disease.

This is also known as having the sickle cell trait.

Getting tested can be particularly useful if you have a family history of sickle cell disease or your partner is known to carry the sickle cell trait.

If you think you could be a carrier, talk to a GP about having the test.

Both men and women can have the test.

Page last reviewed: 16 April 2019 Next review due: 16 April 2022

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Does Scd Happen More Often In A Certain Ethnic Group

SCD occurs most often in people with African ancestry. About 1 in every 12 African Americans is a carrier for SCD. People of Mediterranean, Middle Eastern, Indian, Caribbean, South American, and Central American descent are also at an increased risk of being a carrier. However, SCD can affect people of any ethnic background.

Is Genetic Testing Available

Sickle cell disease

Genetic testing for SCD can be done on a blood sample. Genetic testing, also called DNA testing, looks for genetic variants in HBB genes that cause SCD. If you have questions about genetic testing, talk with your genetic counselor or hematologist. For most children, genetic testing is not necessary for diagnosis. However, it can be helpful for carrier testing or prenatal diagnosis, discussed below.

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About Sickle Cell And Thalassaemia

Sickle cell disease and thalassaemia affect haemoglobin, a part of the blood that carries oxygen around the body.

People who have these health conditions need specialist care throughout their lives.

People with sickle cell:

  • can have episodes of very severe pain
  • can get serious life-threatening infections
  • are usually anaemic

Babies with sickle cell disease can receive early treatment, including vaccinations and antibiotics.

This, along with support from their parents, will help prevent serious illness and allow the child to live a healthier life.

There are also other less common, and less serious, haemoglobin disorders that may be found through screening.

Why Is Sickle Cell Screening Important

Screening for sickle cell disease at birth can save the babys life, Dr. Novelli says.

While in utero, fetuses have mostly normal development, and that process continues after birth until around six months of age. Thats when babies start to produce adult hemoglobin and symptoms start to show, with the most common being extreme pain.

Its important to remember theres enormous variability of presentation of this disease, Dr. Novelli says. Some kids for a number of reasons may be much less affected than others and perhaps spend the first few years of life without symptoms, whereas others can be seriously affected from the get-go.

If sickle cell disease isnt diagnosed at birth, Dr. Novelli says, there is a risk of the baby dying of , an extreme reaction by the body to an infection.

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Why Could I Be Offered Screening For Sickle Cell And Thalassaemia Early In Pregnancy

Screening is offered to find out if you’re a carrier of a gene for sickle cell or thalassaemia and therefore likely to pass it on to your baby.

Genes are the codes in our bodies for things like eye colour and blood group.

Genes work in pairs: for everything we inherit, we get 1 gene from our mother and 1 gene from our father.

People only have sickle cell disease or thalassaemia if they inherit 2 unusual haemoglobin genes: 1 from their mother and 1 from their father.

People who inherit just 1 unusual gene are known as carriers or as having a trait.

Carriers are healthy and do not have the disease.

Sickle cell carriers can experience some problems in situations where their bodies might not get enough oxygen, such as having a general anaesthetic.

All carriers can pass the unusual gene on to their children.

Study Area And Population

Understanding Sickle Cell

Study area

This was a prospective study involving newborns at Muhimbili National Hospital and Temeke Regional Hospital, Dar es Salaam, Tanzania, from January 2015 to November 2016. MNH is the nations tertiary health facility and has been offering SCD services, both clinical and laboratory, for the past three decades, while Temeke Regional Hospital, which is a regional hospital for the Temeke municipality in Dar es Salaam, established SCD services more recently. Both MNH and Temeke Regional Hospital each provide services for residents in Dar es Salaam and the neighboring regions.

Study population

This study involved women who delivered at MNH and Temeke Regional Hospital, and screening involved newborns aged up to 2 d. Informed consent was requested from any woman who agreed for her newborn to be screened. The study excluded all newborns with any illnesses and those whose mothers did not agree to participate in the study. Demographic and contact details were collected prior to the collection of the blood sample using a standard proforma and these were later entered into a project database developed in MySQL .

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