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Abstract
Over the past decades there has been a significant improvement in the care of patients with sickle cell disease (SCD) in high-income countries. However, more needs to be learned about the complex pathophysiology and the factors that contribute to the development of end organ damage from the disease. While antibiotic prophylaxis and appropriate treatment of infections have resulted in a significant reduction of early mortality, management of the painful episodes and prevention of organ damage remain a challenge. Hydroxyurea is the only medication approved as disease-modifying therapy, and bone marrow transplant as curative treatment is not available to most patients. In low-income countries with the highest disease burden, early mortality is high due to limited resources for systematic screening, early diagnosis, and disease management. In order to improve outcomes in patients with SCD in high-income countries, better and widespread implementation of known disease-modifying therapies and the development of newer therapies targeting key pathophysiologic pathways are required. In low-income countries with high disease burden, innovative approaches to develop low-cost diagnostic devices and treatments that can be implemented to scale are needed to combat early mortality from the disease. Sustainable solutions in low-resource settings require evidence-based affordable interventions that can be integrated into primary and secondary healthcare systems.
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102
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Passos-Bueno MR, Bertola D, Horovitz DDG, de Faria Ferraz VE, Brito LA. Genetics and genomics in Brazil: a promising future. Mol Genet Genomic Med 2014; 2:280-91. [PMID: 25077170 PMCID: PMC4113268 DOI: 10.1002/mgg3.95] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Affiliation(s)
- Maria Rita Passos-Bueno
- Centro de Pesquisa sobre o Genoma Humano, Departamento de Genética e Biologia Evolutiva, Instituto de Biociências Universidade de São Paulo São Paulo, Brazil
| | - Debora Bertola
- Centro de Pesquisa sobre o Genoma Humano, Departamento de Genética e Biologia Evolutiva, Instituto de Biociências Universidade de São Paulo São Paulo, Brazil ; Instituto da Criança do Hospital das Clínicas da Faculdade de Medicina Universidade de São Paulo São Paulo, Brazil
| | - Dafne Dain Gandelman Horovitz
- Centro de Genética Médica, Instituto Nacional de Saúde da Mulher, daCriança e do Adolescente Fernandes Figueira, Fundação Oswaldo Cruz Rio de Janeiro, Brazil
| | | | - Luciano Abreu Brito
- Centro de Pesquisa sobre o Genoma Humano, Departamento de Genética e Biologia Evolutiva, Instituto de Biociências Universidade de São Paulo São Paulo, Brazil
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103
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Yue L, Lin M, Chen JT, Zhan XF, Zhong DS, Monte-Nguba SM, Liu PF, Pan XF, Huang JH, Wang X, Ehapo JCS, Eyi UM, Yang HT, Yang LY. Rapid screening for sickle cell disease by polymerase chain reaction-high resolution melting analysis. Mol Med Rep 2014; 9:2479-84. [PMID: 24718623 DOI: 10.3892/mmr.2014.2130] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2013] [Accepted: 03/05/2014] [Indexed: 11/06/2022] Open
Abstract
Each year, ~300,000 individuals with sickle cell disease (SCD), a hemoglobinopathy caused by β-globin gene mutation, are born, and >75% of those are in Africa. The present study examined 511 individuals on the island of Bioko (Equatorial Guinea) and attempted to establish a method for rapid sickle cell disease screening. Following DNA extraction and polymerase chain reaction (PCR) amplification, high resolution melting (HRM) analysis was used to assess the specificity of fluorescence signals of the PCR products and to differentiate various genotypes of these products. The analytical results of HRM were validated using DNA sequencing. By HRM analysis, 80 out of 511 samples were classified as hemoglobin S (Hb S) heterozygotes, while 431 out of 511 samples were classified as wild-type. No mutant homozygote was identified. DNA sequencing indicated that within the 431 wild-type samples as indicated by HRM analysis, one case was actually a Hb S heterozygote and another case was a rare hemoglobin S-C genotype (sickle-hemoglobin C disease). One out of 80 suspected Hb S heterozygotes as indicated by HRM was confirmed as wild-type by DNA sequencing and the results of residual 508 cases were consistent for HRM analysis and sequencing. In conclusion, HRM analysis is a simple, high-efficiency approach for Hb S screening and is useful for early diagnosis of SCD and particularly suitable for application in the African area.
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Affiliation(s)
- Liang Yue
- Medical College of Shantou University, Shantou, Guangdong 515041, P.R. China
| | - Min Lin
- Medical College of Shantou University, Shantou, Guangdong 515041, P.R. China
| | - Jiang-Tao Chen
- Laboratory Medical Center, Huizhou Central People's Hospital, Huizhou, Guangdong 516001, P.R. China
| | - Xiao-Fen Zhan
- Medical College of Shantou University, Shantou, Guangdong 515041, P.R. China
| | - De-Shang Zhong
- The Twenty-Fifth Bath of Chinese Medical Aid Team to the Republic of Equatorial Guinea, Guangzhou, Guangdong 511000, P.R. China
| | | | - Pei-Fen Liu
- The Twenty-Fifth Bath of Chinese Medical Aid Team to the Republic of Equatorial Guinea, Guangzhou, Guangdong 511000, P.R. China
| | - Xue-Fen Pan
- The Twenty-Fifth Bath of Chinese Medical Aid Team to the Republic of Equatorial Guinea, Guangzhou, Guangdong 511000, P.R. China
| | - Jiang-Hua Huang
- The Twenty-Fifth Bath of Chinese Medical Aid Team to the Republic of Equatorial Guinea, Guangzhou, Guangdong 511000, P.R. China
| | - Xi Wang
- The Twenty-Fifth Bath of Chinese Medical Aid Team to the Republic of Equatorial Guinea, Guangzhou, Guangdong 511000, P.R. China
| | | | - Urbano Monsuy Eyi
- Hospital Regional De Malabo, Malabo 999115, The Republic of Equatorial Guinea
| | - Hui-Tian Yang
- Laboratory Medical Center, Chaozhou Central Hospital, Chaozhou, Guangdong 521021, P.R. China
| | - Li-Ye Yang
- Medical College of Shantou University, Shantou, Guangdong 515041, P.R. China
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104
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Peprah E, Wonkam A. Biomedical research, a tool to address the health issues that affect African populations. Global Health 2013; 9:50. [PMID: 24143865 PMCID: PMC4015770 DOI: 10.1186/1744-8603-9-50] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2012] [Accepted: 08/05/2013] [Indexed: 12/22/2022] Open
Abstract
Traditionally, biomedical research endeavors in low to middle resources countries have focused on communicable diseases. However, data collected over the past 20 years by the World Health Organization (WHO) show a significant increase in the number of people suffering from non-communicable diseases (e.g. heart disease, diabetes, cancer and pulmonary diseases). Within the coming years, WHO predicts significant decreases in communicable diseases while non-communicable diseases are expected to double in low and middle income countries in sub-Saharan Africa. The predicted increase in the non-communicable diseases population could be economically burdensome for the basic healthcare infrastructure of countries that lack resources to address this emerging disease burden. Biomedical research could stimulate development of healthcare and biomedical infrastructure. If this development is sustainable, it provides an opportunity to alleviate the burden of both communicable and non-communicable diseases through diagnosis, prevention and treatment. In this paper, we discuss how research using biomedical technology, especially genomics, has produced data that enhances the understanding and treatment of both communicable and non-communicable diseases in sub-Saharan Africa. We further discuss how scientific development can provide opportunities to pursue research areas responsive to the African populations. We limit our discussion to biomedical research in the areas of genomics due to its substantial impact on the scientific community in recent years however, we also recognize that targeted investments in other scientific disciplines could also foster further development in African countries.
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Affiliation(s)
- Emmanuel Peprah
- Current address: National Institutes of Health, Building 1, RM 256A, Bethesda MD 20892, USA
| | - Ambroise Wonkam
- Division of Human Genetics, Faculty of Health Sciences, University of Cape Town, Anzio Road-7925, Observatory, Cape Town, South Africa
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105
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Abstract
David Osrin and Edward Fottrell comment on new research by Frédéric Piel and colleagues on the growing burden of sickle cell anemia, and discuss the need for changing policy and health services in response to epidemiologic transitions in child mortality. Please see later in the article for the Editors' Summary
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Affiliation(s)
- Edward Fottrell
- Institute for Global Health, UCL Institute of Child Health, London, United Kingdom
- Umeå Centre for Global Health Research, Umeå University, Umeå, Sweden
| | - David Osrin
- Institute for Global Health, UCL Institute of Child Health, London, United Kingdom
- * E-mail:
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