....New in Africa, Says Ghanaian Medical Doctor

Philadelphia, PA, Thursday, Nov. 1, 2001 --- Unlike most inward-looking and self-conceited Ghanaian professionals living abroad, Dr. Kwaku Ohene-Frempong, professor of pediatrics at University of Pennsylvania’s medical school, is making real contribution to Ghana’s development by initiating a program for screening newborn babies suspected of having sickle cell disease.

In a presentation at the just-ended “U.S.-Africa Business Summit” in Philadelphia, PA, Dr. Ohene-Frempong pointed out that although sickle cell is a tropical disease, “we don’t read much about it in Africa.” He lamented that “Most children die of sickle cell in Africa at early age without anybody knowing the cause.”

Dr. Ohene-Frempong who is also the Director of Comprehensive Sickle Cell Center at Children’s Hospital of Philadelphia, CHOP, told a roomful of workshop attendees on Thursday, Nov. 1, that as a result of a 1991 meeting with United States medical officials, his group managed to set up a clinic in Kumasi, Ghana’s second largest city, for screening sickle cell disease in babies.

Setting up the clinic in Kumasi is no mere co-incidence, in the early 1960s Ohene-Frempong was a star student athlete coming out of Prempeh College, a well-endowed high school of the period, located in the Ashanti capital. He specialized in hurdling which opened the way for his admission to Yale University in the United States.

According to Dr. Ohene-Frempong, 16,000 babies with sickle cell, a genetically-transmitted disease, are born annually in Ghana. He said it is estimated that 330,000 babies with sickle cell disease are born yearly in Africa as a whole.

“Sickle cell disease facilitates infections that kill children, yet sickle cell is not listed as cause of deaths in Ghana,” Ohene-Frempong pointed out. But with the assistance of the work being done at the newborn screening clinic in Kumasi, the deficiency in identifying sickle cell would change. He said, “Newborn screening is new in Africa.”

Newborn screening allows for early identification of morbid and mortality conditions of babies, Ohene-Frempong explained. He cautioned, though, that screening test alone is not sufficient for identifying and treating sickle cell disease in children; “There must be diagnosis.” He indicated also that there must be clear suspicion of a problem before screening of babies is undertaken.

Speaking on the subject, “Newborn Screening in Ghana: A Penn/CHOP/Ghana Partnership,” Dr. Ohene-Frempong said the program he has initiated makes it possible newborn screening for sickle cell disease in Ghana, for the first time. He indicated that besides early identification and treatment of sickle cell in children, the Kumasi initiative is an educational program for medical practitioners, parents and teachers in the country.

Ghana’s Ministry of Health, CHOP, Kwame Nkrumah University of Science and Technology’s medical school and the Noguchi Memorial Institute for Medical Research in Ghana are the participating agencies of the Kumasi sickle cell screening project, according to Dr. Ohene-Frempong. He indicated that the Noguchi Institute hosts the laboratory work of the sickle cell clinic. The list of Advisory Committee members of the clinic includes medical professionals as well as traditional rulers, among others.

Dr. Ohene-Frempong explained that in Kumasi, children are tested at birth and at local clinics where they go for immunization. He said blood samples are shipped from Kumasi to the Noguchi laboratory in Accra with quick turn around results. “When lab results return to Kumasi, nurses trace the affected mothers by various means and receive treatment.”

Dr. Ohene-Frempong said, “About 2% of babies test positive, but for a large size of population, it is huge.” He said 88% of parents contacted after the test results return for treatment. He indicated that 3% of those receiving treatment die.

For reasons such as poor roads, absence of house numbers and relocation, tracing the mothers whose children test positive of sickle cell disease has been a difficult undertaking, according to Dr. Ohene-Frempong. He indicated also that initial alarm about the “heel stick”, a process for taking blood sample from babies, has been a problem. These problems have also been compounded by various traditional disbeliefs in the diagnosis of the disease.

Tikrom, a village near Kumasi, currently is used as a test case for expanding the program to the rural areas of Ghana, Dr. Ohene-Frempong pointed out.

Like all things African, Dr. Ohene-Frempong signaled that the project could benefit from more funding. Currently, the test cost of about 50 Cents is free to parents as well as the cost of treatment.

When asked to comment on the state of healthcare delivery in Ghana, Dr. Ohene-Frempong said, “We have slipped in the past 25 years, but that is true for all developing countries in Africa.” He said ideas from the Ghana project for screening children with sickle cell would be shared with all of Africa. The Kumasi program is preparing manuals for Africa.

Director-General of Ghana’s public health system has announced the country’s preparedness to go nationwide with the Kumasi sickle cell project.