Sickle Cell Disease and Newborns Screening in Nigeria: A Systematic Review Enhancing Community Level Awareness and Engagement

Abstract

Background and Objectives: Sickle cell disease is one of the most prevalent genetic disorders in Nigeria, contributing significantly to infant and under-five mortality. Despite advances in early detection through newborn screening, uptake in Nigeria remains limited, particularly at the community level. This systematic review aims to assess the level of awareness, acceptance, and community engagement toward newborn screening for sickle cell disease in Nigeria.  Methods: A systematic review was conducted in line with the PRISMA 2020 guidelines. Literature searches were performed across PubMed, Google Scholar, and ResearchGate for studies published between January 2000 and March 2024. Eligible studies included empirical research conducted in Nigeria or comparable sub-Saharan African countries, focusing on awareness, community participation, or implementation of newborn screening for sickle cell disease. Both qualitative and quantitative studies were included. Data were synthesized thematically, and risk of bias was assessed using Critical Appraisal Skills Programme (CASP) and Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) tools.  Results: A total of 468 records were identified; after screening and quality appraisal, 25 studies were included. The review revealed consistently low levels of awareness of sickle cell disease and newborn screening, especially in rural areas. However, acceptance and willingness to participate in screening were high when caregivers were adequately informed. Sociocultural and educational factors including gender roles, stigma, and religious beliefs significantly influenced engagement. Community-based educational interventions, particularly those using faith-based or peer-led platforms, proved effective in increasing uptake. National level screening programs remain limited and poorly integrated into primary healthcare services. Conclusion: Although awareness of sickle cell disease and newborn screening remains low across Nigerian communities, the high level of willingness to participate when informed highlights a critical opportunity for intervention. Culturally sensitive, community-driven education and sustained policy support are essential for improving early detection and reducing the burden of sickle cell disease in Nigeria. Expanding grassroots awareness and integrating newborn screening into routine maternal and child health services should be prioritized in national health planning.