Strategies for reducing child mortality due to sickle cell disease in Uganda: a narrative review

Abstract

Sickle cell disease (SCD) remains a significant contributor to child mortality in Uganda, with an estimated 80% of children born with SCD dying before their fifth birthday, largely due to lack of early diagnosis and inadequate access to comprehensive care. Neonatal screening, although critical for early detection, is limited in Uganda, with coverage rates below 10%. This lack of early diagnosis often leads to delayed treatment and higher mortality rates. Data from recent studies highlight that implementing universal newborn screening could reduce SCD-related mortality by up to 50% if coupled with timely interventions such as prophylactic antibiotics, vaccination, and parental education. Comprehensive care, which includes regular health check-ups, preventive care, pain management, and access to blood transfusions, is essential for improving survival rates among children with SCD. However, in Uganda, only 30% of children with SCD receive regular follow-up care, and access to life-saving interventions like blood transfusions remains limited, especially in rural areas. A study conducted in Uganda found that children with SCD who received regular blood transfusions had a 70% lower risk of stroke and other severe complications compared to those who did not. Strengthening healthcare infrastructure and increasing access to these critical services are crucial to reducing mortality. Community engagement and education play a vital role in reducing SCD-related child mortality. Despite the high burden of SCD, awareness levels among Ugandan communities remain low, contributing to delayed healthcare-seeking behavior and high mortality rates.

Keywords: child mortality; comprehensive care; early diagnosis; health system strengthening; sickle cell disease.