At the age of six months, Haleem’s first-born son, who was initially healthy at birth, began developing bouts of fever and excessive crying. By the time he was nine months old, he had been in and out of hospitals without knowing the correct diagnosis. Eventually, at age 3, he was confirmed at the University teaching hospital to have sickle cell disease.
Haleem’s story, however, represents a bigger challenge on the continent, with medical experts attributing the misdiagnosis of sickle cell and delays in treatment to poor geographical access to expertise and laboratory tests.
Many conditions are not easily recognisable at birth without proper testing. If left untreated, some disorders can cause mental retardation and even death. Newborn screening is a quick and simple way to see if a seemingly healthy infant after birth is at increased risk of having these rare, but serious, conditions. When problems are found early, health conditions can be treated and prevented.
Newborn testing is a public health programme of screening for developmental, genetic, and metabolic disorders in infants shortly after birth. In most cases, these babies look normal and healthy at birth. They usually do not begin showing symptoms until a few weeks or months later.
The goal is to identify infants at risk for these conditions early enough to confirm the diagnosis and provide intervention that will alter the clinical course of the disease and prevent or ameliorate the clinical manifestations.
Dr Idowu Ayede, a consultant neonatologist at the University College Hospital (UCH), Ibadan, said mothers are encouraged to ensure their new babies undergo a newborn screening for many reasons, including blood screening for sickle cell disease.
According to her, “If the parents already know their genotype but still got married, but they are suspecting that the baby could have a sickle cell disease, they want to know the child’s genotype or the older siblings are presenting with sickle cell problems, they can come and screen.”
More than 300 000 babies globally are born every year with sickle cell, a hereditary condition which causes red blood cells to become sickle-shaped. These unusually shaped cells do not live as long as healthy blood cells and can block blood vessels, sometimes resulting in painful swelling or even stroke.
In many countries, families of children with sickle cell grapple with complications of the life-threatening disease, often without knowing the diagnosis, as health systems remain ill-equipped and underfunded to roll out the much-needed newborn screening services.
Dr Ayede said sickle cell disease screening in newborns is done once the child is over 6 months.
“Currently, we have modern equipment to screen for sickle cell disease even on the day of birth, if that is what the parent wants. For the test, 2 to 3 drops of blood are taken from the baby’s heel for routine screening,” she added.
The pediatrician said early newborn screening affords the parent the opportunity to get counsel from the health care provider on the disease and how best to take care of children with sickle cell disease, including recognizing danger signs early.
The children are given pneumococcal vaccines early and commence prophylactic antibiotics. At the same time, malaria and dehydration are prevented. Children with sickle cell disease are prone to develop an infection from some specific group of organisms. Also, when children with sickle cell disease fall ill, they need to seek medical care promptly. Early treatment helps prevents more serious health problems for the baby.
Dr Ayede, however, said many other things are also routinely screened for like the G6PD, congenital hypothyroidism and inborn errors of metabolism.
“We don’t screen routinely for G6PD. Ideally, we should but currently, we don’t. The entry point most of the time for G6PD is when a baby has neonatal jaundice. Then the blood samples are sent for G6PD analysis.”
In addition, newborn screening could include hearing and eye screening for newborns. Sometimes hearing loss is not inherited. For example, it can be caused by an infection during pregnancy.
“Hearing screening for children should be by the second or third day after birth. How well the baby responds to sound is measured. For term babies, we don’t routinely screen the eyes. But preterm babies, particularly those born below 32 weeks, need to have eye screening before and subsequently after they are discharged from the hospital. They are screened for what is medically termed retinopathy of prematurity.”
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The PDP spokesman recalled how the opposition party had on various occasions alerted that the APC government had ceded sovereignty over a large portion of our country to terrorists, “many of whom were imported into our country by the APC.”
He further stated: “From the video, in a brazen manner, terrorists as non-state actors boldly showed their faces, boasting, admitting and confirming their participation in the Kuje Prison break, some of whom were former prison inmates who were either jailed or awaiting trial for their previous terrorism act against our country.
“Nigerians can equally recall the confession by the Governor of Kaduna State, Mallam Nasir el-Rufai that the APC government knows the plans and whereabouts of the terrorists but failed to act.
According to Ologunagba, about 18,000 Nigerians have been killed by terrorists between 2020 and 2022 “as the criminals continue to be emboldened by the failures and obvious complicity of the APC and to which the PDP had always drawn attention.”
“This is not politics; this is about humanity and leadership, which leadership sadly and unfortunately is missing in our country at this time,” he said.
The PDP added that it is appalled by “the lame response by the apparently helpless, clueless and deflated Buhari Presidency, wherein it told an agonizing nation that President Buhari “has done all and even more than what was expected of him as Commander in Chief by way of morale, material and equipment support to the military…”
“This is a direct admission of incapacity and failure by the Buhari Presidency and the APC. At such a time, in other climes, the President directly leads the charge and takes drastic measures to rescue and protect his citizens.
“In time of adversity, the President transmutes into Consoler-in-Chief to give hope and succour to the citizens. Painfully, Nigeria does not have a President who cares and can stand as Consoler-in-Chief to the citizens.
“It has now become very imperative for Nigerians to take note and realize that the only solution to this unfortunate situation is to hold the APC government accountable. We must come together as a people, irrespective of our political, ethnic and religious affiliations to resist the fascist-leaning tendencies of the APC administration.
Ologunagba called for an urgent meeting of the National Council of State to advise on the way to go over the nation’s worsening insecurity.
“Our nation must not fall. The resilient Nigerian spirit and ‘can-do- attitude’ must be rekindled by all to prevail on the President to immediately and without further delay, accede to the demand by the PDP and other well-meaning Nigerians to convene a special session of the National Council of State to find a lasting solution since the President has, in his own admission, come to his wit’s end,” the PDP spokesman declared.
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