A mobile laboratory for screening and monitoring sickle cell patients in rural and remote areas

Sickle cell anaemia is a recessive hereditary disease affecting between 15-25 % of the population in sub-Saharan Africa. Nigeria and the Democratic Republic of Congo (DRC) are the two countries most affected in Africa, with a carrier prevalence (AS) of around 25 %, or one family in four.

The WHO has formulated strategies for the African region, including theewborn screening and early detection especially for children under 5.

Sickle cell disease is a major public health problem, characterised by chronic haemolytic anaemia, painful (vaso-occlusive) attacks, frequent infections and severe complications affecting several organs such as the brain (stroke), kidneys (renal failure), bones (aseptic necrosis) or spleen (hypersplenism, known as "hypersplenism"). kibeka in Lingala, the national language of the DRC).

Mortality is very high where there is no early detection and adequate treatment. It is estimated that 80 % of children in Africa will die before the age of 5, often without even being diagnosed.

To overcome this problem, theIRB 1-HEALTHa research centre of the ASBL DRC EUREKA has launched an original screening and medical monitoring initiative using a mobile laboratory, specially designed for rapid deployment in rural and/or remote areas. The lab, consisting of 2 chambers, includes a haematology unit, a biochemistry unit, a parasitology unit, a cold chain and a small autonomous electrical power unit. There are also plans to introduce rapid diagnostic kits in these rural areas to increase the diagnostic platform with tools that are easy to use and require no electricity or special maintenance.

The project, led by Professor Léon TSHILOLO, a sickle-cell anaemia expert and Director of IRB 1-Health, is targeting nearly 5,000 newborns and children under 5 years of age, and 2,000 women in childbirth, in the provinces of Kongo Central, Kasai-Oriental and Haut Katanga. Patients detected will be cared for and provided with essential products (folic acid, Peni-V, paracetamol), as well as booster vaccines against pneumococcus and other microbes that are dangerous for sickle cell disease sufferers. Severe cases may benefit from a drug called "hydroxyureaThis is the only drug that can reduce serious complications and mortality, and also enable patients to integrate into society again (at school and at work).

This project was made possible thanks to a grant called " Grand Challenge "The Bill ＆ Melinda Gates Foundation provides financial support each year to selected projects in Africa focusing on a research and/or development topic of public interest.

This project, entitled Improving Sickle Cell Disease Care in the Democratic Republic of Congo (DRC) with Mobile Lab Screening"This is an original approach that could help to reduce the inequality of care between sickle cell children living in urban and rural areas.

IRB 1-HEALTH's partners in this project include the Fondation "Novo-Nordisk Haemophilia Foundation"This project combines screening for sickle cell anaemia with screening for haemophilia, another hereditary disease whose patients are just as stigmatised as those with sickle cell anaemia.