Bridging The Gaps In Newborn Screening Programmes: Challenges And Opportunities To Detect Haemoglobinopathies In Africa

Abstract

Background: Hemoglobinopathies, including sickle cell disease and β-thalassemia, are monogenic disorders with a relatively higher prevalence among malaria-endemic areas in Africa. Despite this prevalence, most African countries lack the necessary resources for diagnosing and managing these debilitating conditions. Aim: This study provides a critical review of newborn screening for detecting hemoglobinopathies in Africa, highlighting challenges and proposing strategies for improved diagnosis and management. Methods: A literature search on hemoglobinopathies in Africa was conducted in PubMed. Google Scholar and ScienceDirect, using specific keywords and Boolean operators, including articles published from January 1981 to December 2022. Results: The data show that sickle cell disease is prevalent among populations in Central and West Africa; however, β-thalassaemia is prevalent among people in the northern parts of Africa. Newborn screening pilot initiatives for hemoglobinopathies were being implemented in Angola, Nigeria, Ghana, the Democratic Republic of the Congo, and the Republic of Benin. The cost of testing, lack of sufficient and accessible medical records, and inadequacy in healthcare Infrastructure poses significant challenges in bridging the gaps in newborn screening. Furthermore, the stigmatisation and lack of awareness of hemoglobinopathies and access to Newborn screening programmes pose additional challenges. Conclusion: This review highlights the challenges associated with hemoglobinopathy. testing, effective strategies for mitigating these challenges, and future perspectives for expanding efforts toward detecting and managing these disorders across Africa. Providing affordable diagnostic tools, mobile clinics, government subsidies, education campaigns, and the implementation of electronic medical records systems could help bridge the gaps in newborn screening in Africa. What this study adds: The study presents a comprehensive view of newborn screening. hemoglobinopathies in Africa, provides a detailed outline of the challenges faced by newborn screening for hemoglobinopathies in Africa and offers strategies for better diagnosis and care.