ABSTRACT
This chapter addresses the issue of newborn screening for sickle cell disease (SCD). As will become apparent, newborn screening refers to more than just a laboratory test to identify if an infant has SCD, but rather to a public health programme that screens and follows up infants through diagnosis. The chapter provides a brief introduction to a key organ in SCD, the spleen, and explains the link to newborn screening. The chapter considers the situation before newborn screening for SCD in both more affluent and less affluent parts of the world. In Africa, many pilot projects for newborn screening have been undertaken, but only one has run consistently for more than a generation. In older children with SCD, repeated obstructions of the blood supply in the spleen result in tissue scarring, and the spleen progressively loses its functionality. The importance of enrolment of children with SCD into comprehensive care following identification has frequently been stressed.
