Analysis of Provider Initiated Sickle Cell Disease Screening in Mathare Slums, Nairobi Kenya: A Case of German Doctors, Baraka Health Centre

Abstract

Sickle cell disease (SCD) results in alteration of both hematological and biochemical parameters of the affected individuals. In Kenya, it is estimated that 4,000 children are born with SCD annually; about 21% of children in Kisumu are born with Sickle cell trait. Study objective was to analyze the screening of SCD using various screening techniques at German Doctors-Baraka Health Center in Mathare, Nairobi. On methodology, purposive sampling and cross sectional study design was employed among patients of all ages with clinical features suggestive of SCD. Data utilization permission was sought from hospital administration. Patients’ January 2019 to May 2023 secondary data was extracted from the hospital’s medical records and analyzed using SPSS version 21, the results were presented in percentages. The study found; comprehensive diagnostic approach of SCD facilitated screening of 2053 subjects. About 512 patients were screened by conventional “sickling test” using sodium metabisulphite, 791 by Sickle Cell Scan and 750 by electrophoresis method. Generally, among 2053 subjects screened, the positivity rate was 48.2%. Sickling test positivity rate was 45.9% and 49.1% positivity for Sickle Cell Scan. Sickle Cell Scan screened 791 (49.1%) subjects, and 39.32% of the 791 had homozygous while 9.73% of the 791 were heterozygous forms. Electrophoresis identified forms of sickle cell; with homozygous and heterozygous representing 38.8% and 10% respectively. It concludes that reliability of Sickle Cell Scan and HB electrophoresis are relatively the same based on almost similar rates in identifying true positive cases and the forms of sickle cell disease. The study recommends that clinicians capacity building on managing SCD is required.