Sickle Cell Anemia: a Pediatric-Hematologic Clinic for Nairobi Slums

sickle cell 1Infant mortality in Kenya has declined in the last 10 years, however in 2019 a 45 per mille rate has still been registered for children under the age of five. Non infectious diseases are constantly growing and deaths by non communicable diseases (NCDs) are expected to exceed by 75% the ones caused by infections, malnutrition and pre- and neonatal complications by 2030. Among NCDs, World Health Organization identifies sickle cell anemia as the fourth most spread disease in pediatric age in all Africa.

Sickle cella anemia is a rare pathology in our region, but is frequent in malaria affected areas, such as Kenya, due to genetic reasons. It is a congenital blood pathology that causes high mortality rates and long-term complications if not treated correctly. Hematologic pediatric services available on all African territory are inadequate if compared to the number of patients and often economically accessible, espcially to the population of informal settlements’ in urban contexts. Severe anemia crises are among the most dangerous complications in pediatric age that require emergency interventions.

Blood transfusion centers are often limited and it is difficult to find blood donors. Moreover there is limited availability of medicines, which are valid alternatives to transfusions and able to reduce severe and chronic complications. Currently in Nairobi there are 5 laboratories for sickle cell anemia specific diagnostic tests (hemoglobin electrophoresis). Morover, costs are high compared to the affected patients average income and this frequently leads to late diagnoses and therapy starts. Finally, local staff does not always have sufficient skills to manage these patients and parents or other referral figures (i.e. teachers, community volounteers) have scarse awareness and knowledge of the issue.

The project, co-financed by Chiesa Valdese through Otto per Mille, has as general goal the progressive reduction of mortality and morbidity rates caused by sickle cell anemia by improving the access to basic and specialized quality health services. The project refers in particular to children, mostly by the age of 5, living in North-East Nairobi shantytowns. Expected result of the project is to implement a holistic service for patients, supported by a lab and clinical skilled team.

Main activities:

  • Providing of regular quality pediatric-hematologic clinic services run by skilled personnel.
  • Accurate diagnostic services at Ruaraka Uhai Neema Hospital in the Hematologic section of the Laboratory by implementing specific devices for hemoglobin electrophoresis.
  • Development of a training course and specific protocols to enahnce diagnosis, prevention and treatment of sickle cell anemia in the hospital and in peripheral dispensaries that refer patients.
  • Training, clinical and laboratory activities for local personnel, for parents and community referral figures to develop knowledge, facilitate access to services, reduce urgencies and implement a network on the territory.

This project is implemented in partnership with Children Sickle Cell Foundation (CSCF), a community-based organization made up by parents and patients with the goal of rasing awareness among society on sickle cell anemia. The partnership with CSCF allows to enhanche the capillarity on the territory, involving the R.U. Neema in already used routes for patient issuing, implementing shared protocols and guidelines and raising awareness among the population on different levels. Moreover, the scientific committee of the Foundation will carry out the trainings together with World Friends staff.

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This project is financed by Chiesa Valdese through Otto per Mille.

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