title: A lower-cost protocol for sickle cell disease neonatal screening in Tunisia.
abstract: OBJECTIVE
  Sickle cell disease (SCD) is a group of hereditary chronic anemias that manifest essentially as painful crisis and susceptibility to infection. Neonatal screening is a preventive action that reduces the rates of mortality due to complications arising from infections by encouraging early prophylactic penicillin use and pneumococcal vaccination. The purpose of this pilot study was to set up a neonatal screening protocol at a lower cost than one that uses commercially available screening kits.
  
  
  METHODS
  Pilot study conducted over 1 year in two Tunis maternity hospitals.
  
  
  METHODS
  Samples from 9148 newborns were collected using paper printed using a common office printer to collect blood spots from the newborns. A lab-prepared agarose gel for isoelectrofocusing (IEF) was used to test the dried blood samples from these newborns.
  
  
  RESULTS
  The IEF on lab-prepared agarose gels was efficient since it was able to detect the main abnormal Hbs previously identified in the Tunisian population (HbS, HbC, HbO, and HbG). Furthermore, when data collected in this screening program were compared with the previously established national data, no statistically significant differences were found. After analysis, results were given back to the families of the patients, and the major Hb cases were directed to one of the hemoglobinopathies specialized centers, where at-risk couples benefited from genetic counselling and were informed about the possibility of prenatal diagnosis.
  
  
  CONCLUSIONS
  This pilot experiment demonstrated the feasibility of SCD neonatal detection using a lower cost method as well as detection of other main structural Hb variants.
authors.affiliation: Service de Biochimie Clinique-Hôpital d Enfants de Tunis/Laboratoire de Recherche Lab Santé 01, Tunis, Tunisia. hajer.siala@rns.tn
authors.forename: Siala
authors.initials: S
authors.lastname: Hajer
authors.forename: Taboubi
authors.initials: T
authors.lastname: Neila
authors.forename: Hadj Fradj
authors.initials: HF
authors.lastname: Sondess
authors.forename: Ouenniche
authors.initials: O
authors.lastname: Fekria
authors.forename: Aoun
authors.initials: A
authors.lastname: Nabila
authors.forename: Khedhri
authors.initials: K
authors.lastname: Mahbouba
authors.forename: Douiri
authors.initials: D
authors.lastname: Melika
authors.forename: Ouali
authors.initials: O
authors.lastname: Faida
authors.forename: Bibi
authors.initials: B
authors.lastname: Amina
authors.forename: Belhadj
authors.initials: B
authors.lastname: Raja
authors.forename: Rezigua
authors.initials: R
authors.lastname: Hedi
authors.forename: Meriah
authors.initials: M
authors.lastname: Sadok
authors.forename: Krouf
authors.initials: K
authors.lastname: Naima
authors.forename: Fattoum
authors.initials: F
authors.lastname: Slaheddine
authors.forename: Messaoud
authors.initials: M
authors.lastname: Taieb
mesh_terms: D000755:Anemia, Sickle Cell / Q000097:blood / Q000175:diagnosis*; D006455:Hemoglobins, Abnormal / Q000032:analysis*; D006771:Hospitals, Maternity; D006801:Humans; D007231:Infant, Newborn; D007525:Isoelectric Focusing / Q000191:economics*; D015997:Neonatal Screening / Q000191:economics*; D010865:Pilot Projects; D014416:Tunisia
chemical_list: D006455:Hemoglobins, Abnormal