Our participation in the Angola Sickle Cell Initiative (ASCI) helped to create and implement a comprehensive sickle cell disease initiative in Angola, a country in southwest Africa. This initiative was designed to improve clinical care for children with sickle cell disease. The improvements targeted the screening, diagnosis, care, treatment, monitoring and evaluation of sickle cell patients. In addition, the initiative expanded provisions for research, capacity building, community mobilization, and health professional training in Angola. The Angola Sickle Cell Initiative was formed in 2011 as a partnership between the Angola Ministry of Health, Chevron Corporation, Baylor College of Medicine, and Texas Children’s Hospital.

Activities and Results

Newborn Screening Program (NBS)
The Newborn Screening Program tested newborns at 11 sites in Luanda and 11 in Cabinda from 2011 to 2020. Over 492,000 newborns were screened for sickle cell disease (SCD) and about 2.4 percent of these babies who screened positive were referred for confirmatory testing and treatment as appropriate. This screening program was a critical strategy for reducing SCD-associated morbidity and mortality by facilitating early enrollment in care for affected children, and allowed for an enhanced understanding of the birth prevalence of sickle cell disease in the country. 

Improving sickle cell care
New sickle cell disease management centers were established within municipal hospitals to provide treatment such as penicillin, hydroxyurea, vaccines, and insecticide-treated nets for existing patients with sickle cell disease and those who were through the Newborn Screening Program. These management centers (4 in Luanda and 1 in Cabinda) decentralized care and improved adherence by making it easier for patients to access care closer to home. The Angola Sickle Cell Initiative worked with indigenous healthcare professionals to improve the structure, organization and care that is provided at these very management centers. More than 5,500 patients were enrolled to receive care in these management centers in September 2020. 

To promote long-term sustainability of sickle cell diagnosis and care improvements, indigenous healthcare providers and ancillary service staff, as well as medical and nursing students were trained to screen children for and manage children with sickle cell disease. Consults and training were also provided for other hematological conditions such as hemophilia, aplastic anemia, and leukemia.

A comprehensive multimedia (print and online) training course was developed to train primary care providers in on sickle cell disease diagnosis and management. This course can be accessed at https://txchglobalhope.moodlecloud.com

Contact Us

Gladstone Airewele, MD 
Director, Global Hematology Programs

Elise Ishigami, MBA, MPH
Manager, Global Hematology Oncology Programs