Routine Screening for Sickle Cell Disease during Pregnancy: Epidemiological and Haemoglobin Profile in Congo.

Abstract

Sickle-cell disease, a genetic condition with a high prevalence in sub-Saharan Africa, is transmitted in an autosomal recessive mode. Its screening during pregnancy makes it possible to identify carriers of the S gene which constitute a risk for the unborn child. In order to promote the use of immuno-chromatographic tests, we have set ourselves the task of establishing the epidemiological profile and determining the Emmel test performance. Analytical cross-sectional study of three months duration carried out in the 12 departments of Congo in pregnant women, from 12 weeks of amenorrhea, Admitted for Antenatal Consultation (ANC). The studied variables were epidemiological, Emmel test and immuno-chromatographic profile of haemoglobin. 782 pregnant women screened, of which 27.88% were AS sickle cell trait and 1.79% homozygous SS. The median age of sickle cell patients was 29 years vs. 25 years (p=0.10). High education level, married status, history of transfusion and sickle cell disease, and high ANC number were more common in pregnant sickle cell patients (p<0.05).The frequency of sickle cell trait ranged from 16.67 to 31.17% and homozygous forms from 0 to 66.67% depending on the department. The sensitivity and specificity of the Emmel test were 46% and 99% with PPV and NPV of 95% and 81% respectively. Sickle cell disease carriage, which is high in both forms, is more often of interest to young, educated, married pregnant women and follow-up by health personnel other than the doctor in rural areas.