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October 23, 2009
Sickle Cell Project Making Progress
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The Alcoa Foundation funded Manchester project to prevent sickle cell disease is reaping big benefits after almost two years of research. The project was conceived by the Sickle Cell Trust led by retired Professor of Medicine Graham Serjeant, and also received funding from the National Health Fund, and the Ministry of Health among others.
The project received funding from the Alcoa Foundation through Jamalco because several of the schools targeted are located in Jamalco’s mine operating areas.
The Manchester Project, which began screening in 2007 and will continue for 5 years initially, seeks to determine whether identifying carriers of genes which can result in babies with sickle cell disease, followed by counseling will influence reproductive decisions among prospective parents and reduce the frequency of affected babies.
The project targets the 5th and 6th form students of the 13 secondary schools in Manchester and 2 in Clarendon. To assess the effect, newborn screening for sickle cell disease (SCD) has also been established in Manchester.
The Trust’s report on the project notes that the research is important because “the life-time medical costs to the Jamaican health care system for a sickle cell patient exceed J$1M. The cost of the screening program is J$5.5M annually. Prevention of 5 cases therefore renders it financially self sustaining. More importantly, it will provide the Jamaican Government with a means of diminishing the frequency of SCD. It will also provide a model for other societies to reduce this public health burden.”
Over 4,700 students were screened in the first two years of the project with an overall compliance of 75% students screened and eight schools having 80%. Of the number screened, twenty one (21) cases of sickle cell disease were found, many of whom were not previously diagnosed. Four hundred and forty (440) or 9.25% carry the sickle cell trait. The report also noted a high incidence of iron deficiency among the students screened. It noted that the 99 students were counseled, treated and a repeat blood test to confirm their response to iron.
Newborn screening in Manchester commenced in Mandeville Regional Hospital in August 2008 and in Percy Junor and Hargreaves Memorial Hospital on January 1, 2009. Since then 24 cases of sickle cell disease were found. Before the Manchester Project, no newborn screening for SCD was available outside the corporate area.
The report noted that the expectation is that the number of babies with sickle cell disease will decline as the students who have been identified as carriers have children. All cases of sickle cell disease are followed in special clinics at Mandeville Regional Hospital to provide optimal clinical care.
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