Potential Reduction of Mortality from Invasive Pneumococcal Infection among Children with Sickle Cell Disease in Haiti

Abstract

Main problem background: Acute lower respiratory illness is the most common cause of death among children less than 5 years of age in Haiti. Because children with Sickle Cell Disease (SCD) have a very high risk of contracting invasive pneumococcal infection which may lead to bacteremia and pneumonia, childhood mortality among children with SCD will be significantly higher if they are not diagnosed and receive penicillin prophylaxis and appropriate immunizations. Currently, Pneumococcal 13-valent Conjugate Vaccine (PCV13) is not routinely given to any children in Haiti. Importance: The institution of newborn screening and the routine administration of PCV13 in Haiti should decline the mortality of all children, and in particular the mortality of children with SCD. New finding insights: There is no newborn screening program in Haiti. Limited data suggest that 1 in 173 children born in Haiti will have SCD. We will implement a newborn screening program in Cap Haitien, the second largest city in Haiti, with the purpose of identifying the children with SCD, and assuring they are vaccinated with PCV 13 and receive penicillin prophylaxis. Our hypothesis is that children who are identified through newborn screening with SCD will have a lower mortality rate compared to national statistics. Conclusions: Newborn screening coupled with PCV13 and penicillin prophylaxis will reduce the mortality of infants with SCD as compared to national infant death statistics in Haiti.