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This page was published on 30/09/2009
Published: 30/09/2009


Published: 30 September 2009  
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Environment  |  Health & life sciences


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Sickle cell study recommends immunisation for children

New research shows that the deaths of African children with sickle cell anaemia could be avoided if children are immunised against common infections and newborns are screened for this condition. Published in The Lancet, the results of the Euro-African study indicate that children succumb to this condition because their weak immune systems cannot fight off bacterial infections.

Two red blood cells, the one in the foreground displaying the characteristic 'sickle-shape' common to the disease © EM Unit, UCL Medical School, Royal Free Campus/Wellcome Images
Two red blood cells, the one in the foreground displaying the characteristic 'sickle-shape' common to the disease
© EM Unit, UCL Medical School, Royal Free Campus/Wellcome Images

Sickle cell anaemia rears its ugly head all over the world, but Africa is the prime target, with 200 000 children born with this disorder each year. Sickle cell anaemia is a congenital form of anaemia that is characterised by abnormal blood cells having a crescent shape.

A patient's limbs and organs are most affected because these cells cannot easily pass through blood vessels, and form clusters that can block the flow of blood to areas that need it. A number of complications can emerge including organ damage.

The researchers from Kenya and the UK pointed out that even though there are a high number of cases recorded each year, a staggering 90% of the children die before the disease is ever diagnosed. According to them, diagnosis is frequently delayed.

Researchers have speculated in the past that these deaths are caused by severe infections, but no concrete evidence has ever materialised.

In this study, the researchers from the Kenya Medical Research Institute (KEMRI), along with their colleagues, evaluated the blood samples taken from children aged 14 and under, who were treated at a local hospital in the period between 1998 and 2008. The team screened for cases of bacteraemia (bacterial infections of the blood) and then tested the positive samples for sickle cell anaemia.

The 40 000-strong sample helped the researchers to identify over 2 000 cases of bacteraemia. It should be noted that while less than 3 in 1 000 children in the general population are affected by this condition, the number increases to 60 in 1 000 for children taken to hospital with bacteraemia. According to the researchers, this number proves that African children with sickle cell anaemia are at huge risk of bacteraemia.

'Our study provides a strong impetus for the introduction of vaccination programmes for all children in Africa, a move that will dramatically improve the survival chances of children born with sickle cell anaemia,' explained research leader Dr Tom Williams of the University of Oxford. 'Health policies need to be based on solid evidence such as this research, rather than on rumour and personal preference,' he stressed.

Sickle cell anaemia is responsible for up to 25% of all child deaths in the Kenyan town of Kilifi alone. The majority of these cases are due to bacterial infections, the findings show.

'To date, sickle cell anaemia has not enjoyed a high priority on African health agendas despite the relatively high impact it has on childhood mortality, which far exceeds estimates for HIV [human immunodeficiency virus],' Dr Williams said.

The most common causes of bacteraemia amongst children with sickle cell anaemia include Streptococcus pneumoniae (41% of recorded cases) and Haemophilus influenzae type b (12% of recorded cases). While these cases of bacteraemia can lead to serious illness such as meningitis, they are preventable by vaccination.

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