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Therrell BL, Padilla CD, Borrajo GJC, Khneisser I, Schielen PCJI, Knight-Madden J, Malherbe HL, Kase M. Current Status of Newborn Bloodspot Screening Worldwide 2024: A Comprehensive Review of Recent Activities (2020-2023). Int J Neonatal Screen 2024; 10:38. [PMID: 38920845 PMCID: PMC11203842 DOI: 10.3390/ijns10020038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Revised: 03/28/2024] [Accepted: 03/28/2024] [Indexed: 06/27/2024] Open
Abstract
Newborn bloodspot screening (NBS) began in the early 1960s based on the work of Dr. Robert "Bob" Guthrie in Buffalo, NY, USA. His development of a screening test for phenylketonuria on blood absorbed onto a special filter paper and transported to a remote testing laboratory began it all. Expansion of NBS to large numbers of asymptomatic congenital conditions flourishes in many settings while it has not yet been realized in others. The need for NBS as an efficient and effective public health prevention strategy that contributes to lowered morbidity and mortality wherever it is sustained is well known in the medical field but not necessarily by political policy makers. Acknowledging the value of national NBS reports published in 2007, the authors collaborated to create a worldwide NBS update in 2015. In a continuing attempt to review the progress of NBS globally, and to move towards a more harmonized and equitable screening system, we have updated our 2015 report with information available at the beginning of 2024. Reports on sub-Saharan Africa and the Caribbean, missing in 2015, have been included. Tables popular in the previous report have been updated with an eye towards harmonized comparisons. To emphasize areas needing attention globally, we have used regional tables containing similar listings of conditions screened, numbers of screening laboratories, and time at which specimen collection is recommended. Discussions are limited to bloodspot screening.
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Affiliation(s)
- Bradford L. Therrell
- Department of Pediatrics, University of Texas Health Science Center San Antonio, San Antonio, TX 78229, USA
- National Newborn Screening and Global Resource Center, Austin, TX 78759, USA
| | - Carmencita D. Padilla
- Department of Pediatrics, College of Medicine, University of the Philippines Manila, Manila 1000, Philippines;
| | - Gustavo J. C. Borrajo
- Detección de Errores Congénitos—Fundación Bioquímica Argentina, La Plata 1908, Argentina;
| | - Issam Khneisser
- Jacques LOISELET Genetic and Genomic Medical Center, Faculty of Medicine, Saint Joseph University, Beirut 1104 2020, Lebanon;
| | - Peter C. J. I. Schielen
- Office of the International Society for Neonatal Screening, Reigerskamp 273, 3607 HP Maarssen, The Netherlands;
| | - Jennifer Knight-Madden
- Caribbean Institute for Health Research—Sickle Cell Unit, The University of the West Indies, Mona, Kingston 7, Jamaica;
| | - Helen L. Malherbe
- Centre for Human Metabolomics, North-West University, Potchefstroom 2531, South Africa;
- Rare Diseases South Africa NPC, The Station Office, Bryanston, Sandton 2021, South Africa
| | - Marika Kase
- Strategic Initiatives Reproductive Health, Revvity, PL10, 10101 Turku, Finland;
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Bahram S, Haji A, Abdulwahab H, Mohsen H, Alnashaba T, Al-Aradi Z, Mandeel M. Outcome of premarital genetic counseling for couples at risk of hemoglobinopathies in Kingdom of Bahrain. J Med Screen 2023; 30:161-167. [PMID: 37066693 DOI: 10.1177/09691413231169820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/18/2023]
Abstract
OBJECTIVES Hemoglobinopathies are the commonest inherited blood disorders and form a serious burden worldwide, affecting communities, patient quality of life and healthcare resources. The Kingdom of Bahrain has issued a law obligating couples to undergo premarital screening to detect those at risk of having children affected with these disorders. The aim of this study was to analyze the marital decisions of couples at risk for hemoglobinopathies and follow up the outcomes. METHODS A retrospective study was conducted on couples at risk for hemoglobinopathies identified during the premarital screening program at local health centers in the Kingdom of Bahrain and referred to the genetics department in the Salmaniya Medical Complex for genetic counselling in 2018-2020. RESULTS A total of 189 couples were found to be at risk for hemoglobinopathies, of whom 159 completed the survey. Of these, 107 (67%) decided to proceed with their marriage and 26 couples achieved pregnancy. Out of 24 at-risk pregnancies with known outcome, 83.3% were spontaneous whereas only 16.7% underwent in-vitro fertilization (IVF) with preimplantation genetic diagnosis (PGD). Eight out of 20 infants born to couples after spontaneous conception were affected. A positive attitude toward IVF with PGD was held by 60% of at-risk couples. CONCLUSIONS Despite undergoing premarital screening and genetic counselling, a large percentage of at-risk couples proceeded with their marriage. Most of them justified their decision due to the availability of advanced methods that aid in the prevention of having an affected child. However, the cost of such intervention was a major barrier for the majority of couples.
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Affiliation(s)
- Samya Bahram
- Family Practice Residency Program, Ministry of Health, Manama, Kingdom of Bahrain
- College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Kingdom of Bahrain
| | - Aalaa Haji
- Family Practice Residency Program, Ministry of Health, Manama, Kingdom of Bahrain
| | - Hawra Abdulwahab
- Family Practice Residency Program, Ministry of Health, Manama, Kingdom of Bahrain
| | - Hanan Mohsen
- Family Practice Residency Program, Ministry of Health, Manama, Kingdom of Bahrain
| | - Tahera Alnashaba
- Family Practice Residency Program, Ministry of Health, Manama, Kingdom of Bahrain
| | - Zainab Al-Aradi
- Family Practice Residency Program, Ministry of Health, Manama, Kingdom of Bahrain
| | - Mohamed Mandeel
- Family Practice Residency Program, Ministry of Health, Manama, Kingdom of Bahrain
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Ozdemır S, Oruc MA, Yazıcıoglu B, Turkan S. Premarital hemoglobinopathy screening program results of a province in the Black Sea region of Turkey: three years' experience. Postgrad Med 2023; 135:818-823. [PMID: 38019185 DOI: 10.1080/00325481.2023.2285726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 11/15/2023] [Indexed: 11/30/2023]
Abstract
OBJECTIVES Hemoglobinopathies are a global public health problem with high mortality and morbidity and very expensive treatment. Disease can be reduced and prevented with hemoglobinopathy screening tests. It is possible to identify carriers with the hemoglobinopathy screening program applied in many countries of the world and in Turkey. This study aims to evaluate the results of the national premarital hemoglobinopathy screening program carried out in primary healthcare institutions. METHODS The research is of epidemiological and cross-sectional type. Electrophoresis results examined within the scope of the premarital hemoglobinopathy screening program in Samsun between 1 January 2019 and 31 December 2021 were evaluated retrospectively. Age, gender, year of screening, and hemoglobinopathy screening results were obtained from the records. In the statistical analysis of the data, p < 0.05 was accepted. RESULTS The median age of 52,338 people screened under the hemoglobinopathy screening program was 29.0 (16.0-86.0) years. About 54.1% (n = 28,309) of those who were screened were female, and it was found that the least screening was done in 2020 (n = 15,765 (30.1%)). As a result of the screening, the frequency of the β-thalassemia (β-thal) trait was 1.37% (n = 676), the frequency of the abnormal HbS was 0.04% (n = 20). The frequency of β-thal trait was statistically significantly higher in 2020 (1.5%) compared to other years (p = 0.029). When the results were analyzed by gender, the rate of women with abnormal HbS (3.7%) was significantly higher than the others (p = 0.017). CONCLUSIONS This study presents the results of the national hemoglobinopathy screening program in Northern Turkey and the β-thal and the abnormal HbS rates were found to be low. The data obtained will be useful in monitoring hemoglobinopathy disorders and evaluating the current program's effectiveness in the future. It will allow decision-makers to implement policy changes and prioritize new programs.
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Affiliation(s)
- Sule Ozdemır
- Faculty of Medicine, Department of Public Health, Samsun University, Samsun, Turkey
| | - Muhammet Ali Oruc
- Faculty of Medicine, Department of Family Medicine, Samsun University, Samsun, Turkey
| | - Bahadır Yazıcıoglu
- Samsun Education Research Hospital, Department of Family Medicine, Samsun, Turkey
| | - Sibel Turkan
- Provincial Health Directorate, Department of Public Health, Samsun, Turkey
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Brahmantyo M, Savitri M. Challenge in diagnosis of hemoglobin E/beta thalassemia during pregnancy: A case report. Int J Surg Case Rep 2023; 110:108645. [PMID: 37597431 PMCID: PMC10462833 DOI: 10.1016/j.ijscr.2023.108645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 08/04/2023] [Accepted: 08/05/2023] [Indexed: 08/21/2023] Open
Abstract
INTRODUCTION Beta thalassemia (β-thalassemia) in pregnant women increases the risk of obstetric problems such as premature birth and low birth weight, so caution is needed in its management; these cases are usually asymptomatic. PRESENTATION OF CASE A pregnant Indonesian female (gestational age of 36 weeks), 21 years old, complained of general weakness. The patient experienced anemia several times during this pregnancy and received several blood transfusions. Her parents also have β-thalassemia. A physical examination of the patient showed pale conjunctiva and slight icteric sclera. Laboratory examination showed abnormal included hemoglobin (Hb) of 6.7 g/dL, hematocrit of 207 %, mean corpuscular volume (MCV) of 60.1 fL, mean corpuscular hemoglobin (MCH) of 19.3 pg, mean corpuscular hemoglobin concentration (MCHC) of 32.1 g/dL, albumin of 3.06 g/dL, direct bilirubin of 0.75 mg/dL, and total bilirubin of 1.78 mg/dL. Peripheral blood smear examination showed β-thalassemia. She received a high-calorie and protein diet with extra eggwhite of 2100 kcal/day, leukodepleted packed red blood cell (LD-PRBC) transfusion of 2 × 250 cc/day, folic acid of 3 × 1 mg/day, and methylprednisolone of 3 × 62.5 mg/day. The patient gave birth to a baby girl spontaneously. She received methylprednisolone of 3 × 16 mg with tapering off every week and folic acid of 3 × 1 mg. The patient's prognosis showed improvement. DISCUSSION Pregnancy weakens the immune system; therefore β-thalassemia is frequently discovered during this time, and keeping the mother's Hb ≥10 g/dL prevents complications. CONCLUSION Maintaining Hb ≥10 g/dL minimizes complications for mother and baby.
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Affiliation(s)
- Median Brahmantyo
- Department of Internal Medicine, Faculty of Medicine, Airlangga University - Dr. Soetomo, General Academic Hospital, Surabaya, Indonesia
| | - Merlyna Savitri
- Department of Internal Medicine, Faculty of Medicine, Airlangga University - Dr. Soetomo, General Academic Hospital, Surabaya, Indonesia.
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Colombatti R, Hegemann I, Medici M, Birkegård C. Systematic Literature Review Shows Gaps in Data on Global Prevalence and Birth Prevalence of Sickle Cell Disease and Sickle Cell Trait: Call for Action to Scale Up and Harmonize Data Collection. J Clin Med 2023; 12:5538. [PMID: 37685604 PMCID: PMC10488271 DOI: 10.3390/jcm12175538] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 08/18/2023] [Accepted: 08/22/2023] [Indexed: 09/10/2023] Open
Abstract
Sickle cell disease (SCD) is an inherited monogenic disorder with high prevalence throughout sub-Saharan Africa, the Mediterranean basin, the Middle East, and India. Sources of SCD epidemiology remain scarce and fragmented. A systematic literature review (SLR) to identify peer-reviewed studies on SCD epidemiology was performed, with a search of bibliographic databases and key conference proceedings from 1 January 2010 to 25 March 2022 (congress abstracts after 2018). The SLR followed PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Meta-analyses, using a binomial normal random-effects model, were performed to estimate global and regional prevalence and birth prevalence. Of 1770 journal articles and 468 abstracts screened, 115 publications met the inclusion criteria. Prevalence was highest in Africa (~800/100,000), followed by the Middle East (~200/100,000) and India (~100/100,000), in contrast to ~30/100,000 in Europe. Birth prevalence was highest in Africa (~1000/100,000) and lowest in North America (~50/100,000) and Europe (~30/100,000). This SLR confirmed that sub-Saharan and North-East Africa, India, the Middle East, and the Caribbean islands are global SCD hotspots. Publications including mortality data were sparse, and no conclusions could be drawn about mortality. The identified data were limited due to gaps in the published literature for large parts of the world population; the inconsistent reporting of SCD genotypes, diagnostic criteria, and settings; and a sparsity of peer-reviewed publications from countries with assumed high prevalence. This SLR demonstrated a lack of systematic knowledge and a need to provide uniform data collection on SCD prevalence and mortality.
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Affiliation(s)
- Raffaella Colombatti
- Clinic of Pediatric Hematology Oncology, Department of Child and Maternal Health, Azienda Ospedaliera, University of Padova, 35122 Padua, Italy
| | | | - Morten Medici
- Novo Nordisk A/S, 2860 Søborg, Denmark; (M.M.); (C.B.)
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Galadanci AA, Estepp JH, Khan H, Farouk ZL, Caroll Y, Hodges J, Yarima S, Ibrahim UA, Idris IM, Gambo A, Hussaini N, Mukaddas A, DeBaun MR, Galadanci NA. Barriers and Facilitators of Premarital Genetic Counseling for Sickle Cell Disease in Northern Nigeria. J Pediatr Hematol Oncol 2023; 45:e716-e722. [PMID: 37494609 DOI: 10.1097/mph.0000000000002702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Accepted: 05/24/2023] [Indexed: 07/28/2023]
Abstract
In high-income countries, premarital genetic counseling for Sickle Cell Disease (SCD) is a standard practice. However, in Nigeria, there is no formal premarital genetic counseling program available for SCD. We conducted a series of focus group discussions with health care professionals, patients with SCD, and parents of the patients with or without SCD to gain an understanding of their attitudes and beliefs towards SCD/Sickle Cell Trait and premarital genetic counseling for SCD. Data were analyzed using Charmaz's constructivist grounded theory approach. Two themes were highlighted in the analysis as follows: (1) the difference between the perception of premarital sickle cell screening among individuals with SCD versus the general population, and (2) the personal beliefs and physical challenges that could lead to the avoidance of premarital screening within the general community. Lack of disease-related knowledge, testing facilities, transportation, and stigma associated with the disease were the most commonly perceived barriers to premarital testing. Also, a willingness to receive premarital testing for SCD exists within our community to reduce the spread of the disease and advocate for improved health-related quality of life of patients with SCD. The content and structure of a premarital genetic counseling program in Kano, Northern Nigeria, needs to be developed.
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Affiliation(s)
| | | | - Hamda Khan
- Department of Hematology, St Jude Children's Research Hospital, Memphis
| | - Zubaida L Farouk
- Centre for Infectious Diseases Research, Bayero University, Kano
| | - Yvonne Caroll
- Department of Hematology, St Jude Children's Research Hospital, Memphis
| | - Jason Hodges
- Department of Hematology, St Jude Children's Research Hospital, Memphis
| | | | | | | | - Awwal Gambo
- Department of Pediatrics, Murtala Mohammed Specialist Hospital, Kano Nigeria
| | - Nafiu Hussaini
- Department of Mathematical Sciences, Bayero University Kano
| | | | - Michael R DeBaun
- Department of Pediatrics, Division of Hematology and Oncology, Vanderbilt-Meharry-Matthew Walker Center of Excellence in Sickle Cell Disease, Vanderbilt University Medical Center, Nashville, TN
| | - Najibah A Galadanci
- Department of Medicine, Division of Hematology and Oncology, University of Alabama at Birmingham, Birmingham, AL
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Vargas-Hernández DA, Uscategui-Ruiz AC, De Avila J, Romero-Sánchez C. Differences in the distribution of hemoglobin variants according to the geographic regions in a Colombian population. Hematol Transfus Cell Ther 2023; 45 Suppl 2:S140-S147. [PMID: 36764860 PMCID: PMC10433307 DOI: 10.1016/j.htct.2022.11.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 07/24/2022] [Accepted: 11/24/2022] [Indexed: 02/01/2023] Open
Abstract
INTRODUCTION Colombia has been subject to intense genetic and cultural currents due to its geographical location. Hemoglobinopathies are the most common recessive diseases found worldwide and represent an important public health problem, according to the region and ancestry of each country. OBJECTIVES To evaluate the frequency of hemoglobin variants according to the geographical region in a population group adjusted to sex and age in Colombia. METHODS This was a descriptive retrospective study of hemoglobin variants performed by electrophoresis in patients treated at and/or referred to specialized care institutions in Bogota, Colombia between January 2009 and December 2020. RESULTS A total of 2,224 results were analyzed, 48.4% male and 51.5% female; 63.3% of patients were without alterations, 14.3% presented with thalassemia, 17.3%, HbS, 2.3%, HbS/C, 1.8%, HbC, 0.5%, HbE and 0.5% persistent HbF, with HbS being more prevalent in males (p = 0.005). When assessing the geographical regions of Colombia, a higher prevalence of HbS was found in the Pacific (p = 0.005) and Caribbean regions, while Thalassemia and HbS were more prevalent in the Andean and Orinoquia regions, and it was rare to find any hemoglobinopathies (p = 0.0001) in the Amazonian region. CONCLUSIONS The main hemoglobinopathies found in Colombia are HbS, predominantly in males, and Thalassemia. The distribution of hemoglobinopathies in different geographical regions of Colombia is influenced by ancestry.
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Affiliation(s)
- Diego A Vargas-Hernández
- Universidad Militar Nueva Granada, Medical School, Bogotá, Colombia; Hospital Militar Central, Department of Internal Medicine, Bogota, Colombia.
| | - Adriana Catalina Uscategui-Ruiz
- Universidad Militar Nueva Granada, Medical School, Bogotá, Colombia; Hospital Militar Central, Department of Internal Medicine, Bogota, Colombia
| | - Juliette De Avila
- Universidad El Bosque, Cellular and Molecular Immunology Group/INMUBO, Bogotá, Colombia
| | - Consuelo Romero-Sánchez
- Universidad Militar Nueva Granada, Medical School, Bogotá, Colombia; Universidad El Bosque, Cellular and Molecular Immunology Group/INMUBO, Bogotá, Colombia.
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Kavanagh PL, Fasipe T, Wun T. A Review of Sickle Cell Disease-Reply. JAMA 2022; 328:1979-1980. [PMID: 36378210 DOI: 10.1001/jama.2022.16735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
| | | | - Ted Wun
- University of California-Davis School of Medicine, Sacramento
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Knowledge and Perception of and Attitude toward a Premarital Screening Program in Qatar: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19074418. [PMID: 35410099 PMCID: PMC8998822 DOI: 10.3390/ijerph19074418] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 03/29/2022] [Accepted: 03/30/2022] [Indexed: 12/04/2022]
Abstract
Premarital screening (PMS) is a primary preventive measure to decrease the incidence of certain genetic disorders and sexually transmitted diseases. This study aimed to explore the knowledge and perception of and the attitude toward PMS and predictors of knowledge and attitude. A cross-sectional study was conducted among Qatar University students using an online survey. Multivariable regression analyses were used to identify factors associated with PMS knowledge and attitude. A total of 476 students participated in the study; 424 (89.1%) were females; two-thirds were 18–21 years old. Only 100 participants had heard about PMS. Knowledge of PMS was significantly associated with females, students enrolled in a health-related college, and non-consanguineous marriage of a participant’s parents. The majority of the participants agreed that genetic diseases are psychological and economic burdens. For attitude, only 178 participants were willing to cancel marriages, given incompatible PMS results. The following factors were positively associated with attitude: PMS knowledge, enrollment in a health-related college, and the belief that PMS does not interfere with destiny. Our study findings revealed that despite the mandatory PMS in Qatar, the study participants, future couples, had low knowledge about the program. Therefore, strategies to increase awareness of PMS should be considered toward improving its outcomes.
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