P-053: SICKLE CELL MANAGEMENT AND INTERNATIONAL COOPERATION

Abstract

Purpose: Introduction: Sickle cell disease management is a public health problem in developing countries. According to the World Health Organization (WHO), more than 300,000 of the 500,000 annual births with sickle cell gene, in the world live in Africa, particulary in the sub-Saharan region. The risk of infant mortality is 50% to 80% in the lack of quick and appropriate care. In Senegal, the gene frequency is estimated at 10%, with 0.5% of annual births of major forms, (1700 newborns per year). In order to improve the management of this disease, Senegal State and Monaco Principality have co-financed a dedicated structure: Ambulatory Care Unit for Children and Adolescents with Sickle Cell Disease (USAD), in the National Children Hospital Albert Royer in Dakar, as part of a project with a partnership agreement. The main missions are care, training and research. Materials and methods: Methods: In order to share the results of the first four years, we used data from the project’s activity reports and the Hospital’s Medical Information Service. Results: Results: between 2017 and 2020, 14899 consultations were carried out, on average: 3700/year, including 4604 Emergencies, on average 1151/year and 1062 new cases, on average: 265/year. During the same period, 743 long-term hospitalizations were carried out, an average of 186/year. The number of daily hospitalizations was 2686, an average of 672/year. In 2020, according to SIM statistics, the management of sickle cell disease occupied the 1st place in specialized consultations at the hospital, and was the 1st reason for hospitalization in the two main general pediatrics Units (Unit M and Unit K). About the laboratory, 4099 complete blood counts were performed with 3063 Hb electrophoresis and 797 thick drops. Concerning the training of human resources, 8 paediatricians were certified in the management of sickle cell disease. In addition, 64 doctors and 82 nurses received capacity building. Advanced training courses were organized for 6 nurses and a laboratory technician. Associative activities made it possible to organize 28 talks with 2,831 people made aware of sickle cell disease. Three communications plan development workshops were organized with 60 people as well as training in social communication for 90 members of the association with the production of 1,800 awareness leaflets on sickle cell disease. Conclusion: Discussion and Conclusion: Sickle cell disease is a neglected disease that can be functionally or life-threatening. Its management requires a national and international commitment. The State of Senegal and the Monegasque Cooperation have contributed to improving the diagnosis and supported. However, the main challenges remain the sustainability and the implementation of neonatal screening, as part of a national program to fight against sickle cell disease. Keywords: sickle cell disease, management, cooperation. The authors do not declare any conflict of interest