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

Sickle cell disease is a recessive hereditary disease that affects 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 prevalence of carriers (AS) around 25%, or one in four families.

WHO has formulated strategies for the African region which include neonatal screening and early detection especially for children under 5 years of age.

Sickle cell disease is a major public health problem, characterized by chronic hemolytic anemia, painful crises (vaso-occlusive), frequent infections and severe complications affecting several organs such as the brain (strokes), kidneys (renal failure), bones (aseptic necrosis) or spleen (hypersplenism, called kibeka in Lingala, the national language in the DRC).

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

To overcome this problem, the IRB 1-HEALTH, a research center of the non-profit organization DRC EUREKA, has undertaken an original initiative for screening and medical monitoring using a mobile laboratory, specially designed to be deployed quickly in rural and/or remote areas. This lab, composed of 2 boxes, includes a hematology unit, a biochemistry unit, a parasitology unit, a cold chain and a small autonomous electrical power unit. It is also planned to introduce rapid diagnostic kits in these rural areas in order to increase the diagnostic platform with simple-to-use tools that do not require electrical energy sources or special maintenance.

This project, led by Professor Léon TSHILOLO, sickle cell expert and Director of IRB 1-Health, targets nearly 5,000 newborns and children under 5 years old and 2,000 parturients in the provinces of Kongo Central, Kasai Oriental and Haut Katanga. Screened patients will be treated and will receive essential products (folic acid, Peni-V, Paracetamol), as well as boosters of vaccines against pneumococcus and other dangerous microbes for sickle cell patients. Severe cases will be able to benefit from a drug called "hydroxyurea", the only drug that reduces serious complications and mortality and also allows patients to reintegrate into society (school and professional world).

This project was made possible by a grant called the “ Grand Challenge ” from the Bill & Melinda Gates Foundation. which provides financial support each year to selected projects in Africa which focus on a research and/or development topic of public interest.

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

IRB 1-HEALTH counts among its partners in this project the Novo-Nordisk Haemophilia Foundation , which supports the Hemodrepa project, which combines screening for sickle cell disease with screening for hemophilia, another hereditary disease whose patients are also victims of stigmatization, like sickle cell patients.