Abstract
In the Democratic Republic of the Congo, the sickle cell trait carriage is estimated at 25%. Routine neonatal screening is not a common practice, leading to a very late diagnosis. In this study, the screening of pregnant women was assessed as well as their attitudes. This is an analytical cross-sectional study conducted in 245 pregnant women, sampled by convenience in four hospitals in Kisangani city (Democratic Republic of Congo) and screened using the sickle SCAN® test, from February 1 to July 31, 2019. The sensitivity and specificity of the latter were determined using liquid chromatography coupled with mass spectrometry as the gold standard. The attitudes of 240 pregnant women without previous screening history were assessed upon the announcement of the results. The sensitivity of screening for hemoglobin (Hb) AA and Hb AS was 96.69% and 98.39%, respectively; while the specificities were 99.43% and 96.32%, respectively. The Kappa coefficient (κ) was excellent. Concerning attitudes, Hb SS pregnant women and 55.17% of AS pregnant women worried when the results relating to their hemoglobin status were announced. The sickle SCAN® test was found reliable for sickle cell disease screening in Kisangani. The announcement of the results, mainly positive, raises worry among pregnant woman. Therefore, we recommend the involvement of a clinician psychologist for pre-screening counselling and for results announcement, as well as early newborns and unmarried teenage girls screening.
Highlights
As indicated by the World Health Organization (WHO) in its 2008 report, hemoglobin disorders are a significant health problem in 71% of the world’s 229 countries
The screening of pregnant women was assessed as well as their attitudes. This is an analytical cross-sectional study conducted in 245 pregnant women, sampled by convenience in four hospitals in Kisangani city (Democratic Republic of Congo) and screened using the sickle SCAN® test, from February 1 to July 31, 2019
In relation to household durable assets, we looked for whether or not households owned: television, radio, vehicle and refrigerator, and mobile phone; and in relation to housing characteristics, we investigated the availability of electricity, the supply of drinking water, the use of modern toilets, the construction of walls made of durable materials, and the use of embers or stoves as fuel for cooking
Summary
As indicated by the World Health Organization (WHO) in its 2008 report, hemoglobin disorders are a significant health problem in 71% of the world’s 229 countries They account for 89 per cent of the world’s birth rate [1]. According to the global hemoglobinopathy epidemiology database, approximately 7% of pregnant women are carriers of hemoglobinopathies; more than 9 million carriers of the sickle cell trait (SCT) HbAS women become pregnant each year; and there are approximately 948,000 new couples with SCD risk (1% of couples) and more than 1.7 million pregnancies in carrier couples. In Africa, the high prevalence of SCT makes it a public health concern. This prevalence varies by region, from 10% to 40% in equatorial Africa, from 15% to 30% in western Africa [3]
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