kenya sickle cell care · 2017. 11. 9. · kenya & sickle cell disease (scd) (2) •in kenya,...
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Kenya Sickle Cell Care
Made possible by the generous support of the Indiana Hemophilia & Thrombosis Center. Partners with AMPATH Hematology
Title name: Outreach Programs and Advocacy of Sickle Cell Disease Care in Kenya Presenter: Samuel Misiani Mbunya Administrator: AMPATH Hematology
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KENYA & Sickle Cell Disease (SCD) (1)
•Kenya: East Africa
•Approx. Population: 45,000,000
•Western and Coastal Regions mostly affected
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KENYA & Sickle Cell Disease (SCD) (2)
• In Kenya, SCD is the hereditary hemolytic anemia accounting for over 15% of all childhood anemia (Kasili et al., 1982).
• The occurrence of sickle cell trait varies from less than 1% among the ethnic groups of the Kenyan central highlands to as high as 20-25% in those inhabiting the malaria holoendemic coastal and the lake belts of the country (Kasili et al., 1982).
• A national survey of SCA patients in Kenya was done between Nov 1987 to May 1990, revealing 3605 cases, 80% of which belonged to Luo and Luhya ethnic origins (Aluoch, et al. 1993). These communities reside near and around Moi Teaching and Referral Hospital (MTRH).
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AMPATH Hematology Program
• Initiated in 2011
• Support from the Indiana Hemophilia and Thrombosis Centre (IHTC).
• Embarked on research, outreach SCD care and educational programs.
• Focus on health institutions as well as communities to create awareness on SCD.
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Education & Training
• Targeting multidisciplinary teams of health workers across Kenya
• Educate and train patients on the management of SCD
• Focus on education of the disease, testing and treatment/care.
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Community Education & Advocacy
• local communities are educated and the creation of awareness about SCD is provided.
• Families and PWSCD are involved in creating awareness
• Platform for health worker vs community sensitization.
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School & Home Visits
• Educate children and parents, including teachers from various schools about SCD
• Teacher and student relations to understand SCD and its management.
• Increase awareness and advocacy
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Diagnostic Services • Provision of high quality
Sickle Cell Disease diagnostic services
• Iso Electric Focusing (IEF) in the New Born Units (NBU) and Immunization Clinics
• HB Electrophoresis (Confirmatory testing for SCD)
• Pilot Point of Care (POC) test (Sickle Scan)
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Treatment Medications
• Hydroxyurea 500mg
• Penicillin Tablets 250mg
• Penicillin Syrup 250mg
• Paludrine Tablets 100mg
• Folic Acid
• Pneumococcal and Meningococcal Vaccines
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Recent Research Studies
• FEASIBILITY AND EFFECTIVENESS OF HYDROXYUREA IN A SUB- SAHARAN AFRICAN POPULATION WITH SICKLE CELL DISEASE (2011)
• VALIDATION OF HEMOTYPE SCTM DIAGNOSTIC TEST FOR SICKLE CELL DISEASE IN NEWBORNS AND INFANTS AGES 0 TO 12 MONTHS (2017/2018)
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Outreach Clinical Care Program
• Provision of high quality Sickle Cell Disease care and treatment.
• Consultation services to patients in the comprehensive care clinics
• Interactive sessions to healthcare providers during ward rounds
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Patient support
• Provide support to the patients through community leaders.
• Interactive sessions with families and patients
• Partnerships with Kenya Sickle Cell Disease Foundations
• Creation of social media groups through WhatsApp for information
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Challenges & Obstacles • Lab (Consistency & Turn around times)
• Patient follow up after testing & results
• Socio economic challenges for patients (costs related to tests, medications & travel to clinics)
• Collaborative challenges with rural hospitals on integration of POC programs
• Sustainability of funding for the outreach clinics
• Advanced training & supervision to improve laboratory services
• Immediate & consistent communication follow up to families
• Waiver systems, Revolving Fund Pharmacy (RFP) & transport reimbursements
• Continued trainings and follow up of true partnerships
• Involvement of County Governments for sustainable clinical programs
Way forward
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Community Service
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Results
• More than 700 healthcare providers in Kenya have been trained
• 2 County and 1 Sub County hospitals initiated in the comprehensive outreach care clinics.
• More than 50 local healthcare providers trained and administering care.
• 20 Schools have been visited and trained,20 patient home visits have been done.
• During the visits and trainings emphasis is made on ensuring proper understanding of Sickle Cell Disease and its management.
• A good referral system has been developed for Sickle Cell Disease with a robust patient follow up system.
• Health professional, nurses, doctors from all over the country have been educated by experts in the care of Sickle Cell Disease patients.
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Conclusion
• Awareness about Sickle Cell Disease in Kenya has been increased.
• This has resulted in a greater number of patients being treated with prophylactic penicillin and antimalarials where indicated, and greater access to prescribing of hydroxyurea.
• There is also improved knowledge about management of patients when hospitalized acutely.
• Increased education, training and capacity building in Kenya.
• It is anticipated that these measures will lead to a reduction in morbidity and mortality from Sickle Cell Disease.
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References
• Kasili E and Bwibo N. Hematopathological observations in Kenyan children with sickle cell anemia in the first decade of life. Am J Pediatr Hematol Oncol. 1982; 4 (2):182-6
• Aluoch et al., Survey of sickle cell disease in Kenya, Trop Geogr Med. 1993; 45(1):18-21.
• British journal of hematology, HemoType SCTmCharles T. Quinn,1 Mary C. Paniagua,1 Robert K. DiNello,2 Anand Panchaland Mark Geisberg2,1Cincinnati Children’s Hospital Medical Center,Cincinnati, OH, and 2Silver Lake ResearchCorporation, Azusa, CA, USA
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AMPATH Hematology Team
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For more information and also collaborative partnerships:- • Samuel Misiani Mbunya • Email: [email protected] • Cell: +254716568562 • Website: www.ampathkenya.org