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Testing for sickle cell urged.

Guidelines issued by a federally supported panel of experts call for screening all newborns for sickle cell disease, a genetic disorder that is most common among blacks but which can strike others with ancestors from the Caribbean, South and Central America, Turkey, Greece, the Middle East and India.

A committee of physicians, scientists and patient representatives commissioned by the Agency for Health Care Policy and Research issued the new clinical guidelines in April 1993.

The group called for universal screening because it said early medical treatment can significantly reduce the rate of illness and death caused by sickle cell disease.

Universal screening already is performed in 34 states, while targeted screening is conducted in others.

Sickle cell disease is an inherited condition in which red blood cells, the oxygen-carrying component of the blood, change from a normal disc shape to a crescent, or sickle, shape. This leads to the death of cells and damage to body tissue.

The most common form of the disorder, sickle cell anemia, can cause jaundice, muscular and joint pain, skin ulcers, gallstones and early childhood death. About one in every 375 African-Americans is affected.

The disease develops when a baby inherits the sickle cell trait from both parents. About eight percent of the African-American population caries the gene pattern for sickle cell. The incidence is lower in other population groups. When both parents have the trait, the chances are one in four that their baby will inherit it.

Under the new guidelines, the committee recommended that blood tests for sickle cell disease be added to the other screening tests that are now routinely conducted for newborns.

If a baby is found to have sickle cell anemia, the panel recommends that it be treated with penicillin starting at about 2 months after birth and continuing until at least age 5. This therapy can reduce bacterial infections and pneumonia, a major cause of deaths among sickle cell anemia patients, the guidelines say.

The committee also recommended that parents of sickle cell anemia children be taught to watch for symptoms of developing complications, such as fever, unusual sleepiness or irritability, rapid breathing or vomiting. The guidelines also called for regular medical checkups, along with close attention to immunizations.
COPYRIGHT 1993 Association of Labor Assistants & Childbirth Educators
No portion of this article can be reproduced without the express written permission from the copyright holder.
Copyright 1993, Gale Group. All rights reserved. Gale Group is a Thomson Corporation Company.

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Title Annotation:screening of all newborns
Publication:Special Delivery
Date:Jun 22, 1993
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