title: Incidence of sickle cell disease and other hemoglobin variants in 10,095 Lebanese neonates.
abstract: Hemoglobinopathies are highly prevalent diseases and impose a public health burden. Early diagnosis and treatment can ameliorate the course of these diseases and improve survival. Despite purported high incidence of hemoglobinopathies in Lebanon, there are no nationwide screening programs. In this study, newborn screening utilizing high pressure liquid chromatography was executed in all public hospitals across Lebanon between 2010 and 2013. All newborns with an abnormal hemoglobin (Hb) were offered genetic counseling and all those with disease were enrolled in comprehensive hemoglobinopathy clinics. Among newborns, 2.1% were found to have an abnormal Hb variant with sickle Hb being the most common while 0.1% were found to have sickle cell disease (SCD). The majority of those with SCD had non-Lebanese origins. The most common causes of hospitalizations in infants with SCD were acute splenic sequestration and pain crises. No bacteremia or other life threatening infections were noted. At a median follow up 14 months (follow up range 7 to 34 months), all children with disease are alive and compliant with treatment. Systematic screening for SCD and other Hb variants was shown to be feasible, cost effective, and of accurate predictive value. This program was also clinically effective because it led to the identification of babies with disease and to providing them with free early multidisciplinary care. Conclusively, a newborn screening program should be implemented across Lebanon to detect hemoglobinopathies and initiate early therapeutic and preventive strategies and genetic counseling.
authors.affiliation: Department of Pediatrics, State University of New York, Syracuse, New York, United States of America.
authors.forename: Evelyne
authors.initials: E
authors.lastname: Khoriaty
authors.affiliation: School of Medicine, Lebanese American University, Byblos, Lebanon.
authors.forename: Rim
authors.initials: R
authors.lastname: Halaby
authors.affiliation: School of Medicine, Lebanese American University, Byblos, Lebanon.
authors.forename: Mohamad
authors.initials: M
authors.lastname: Berro
authors.affiliation: School of Medicine, Lebanese American University, Byblos, Lebanon.
authors.forename: Ahmad
authors.initials: A
authors.lastname: Sweid
authors.affiliation: School of Medicine, American University of Beirut Medical Center, Beirut, Lebanon.
authors.forename: Hussein A
authors.initials: HA
authors.lastname: Abbas
authors.affiliation: School of Medicine, Lebanese American University, Byblos, Lebanon; Lebanese American University and Division of Pediatric Hematology-Oncology, Rafic Hariri University Hospital, Beirut, Lebanon.
authors.forename: Adlette
authors.initials: A
authors.lastname: Inati
mesh_terms: D000755:Anemia, Sickle Cell / Q000453:epidemiology* / Q000235:genetics*; D003241:Consanguinity; D005260:Female; D006455:Hemoglobins, Abnormal / Q000235:genetics*; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D007861:Lebanon / Q000453:epidemiology; D008297:Male; D015997:Neonatal Screening
chemical_list: D006455:Hemoglobins, Abnormal