African Genetic Counseling | 22 April 2004
A Comparative Study of Point-of-Care Haemoglobin Electrophoresis for Newborn Screening in Rural Sierra Leone: A Cost-Effectiveness Analysis from an African Perspective
K, a, d, i, a, t, u, S, e, s, a, y, ,, S, a, m, u, e, l, B, a, n, g, u, r, a
Abstract
Sickle cell disease (SCD) is a significant public health burden in sub-Saharan Africa, contributing to high infant mortality. Conventional newborn screening using laboratory-based haemoglobin electrophoresis is frequently inaccessible in rural areas due to cost and logistical challenges. This study aimed to compare the cost-effectiveness of a point-of-care (POC) haemoglobin electrophoresis device against a standard laboratory-based approach for newborn screening in rural Sierra Leone. A comparative cost-effectiveness analysis was conducted from a healthcare provider perspective. Two rural districts were modelled: one using a POC device and the other using the central laboratory pathway. Data on costs, test turnaround times, and projected health outcomes were analysed to determine the incremental cost-effectiveness ratio. The POC strategy was more cost-effective for rural screening. It reduced the mean turnaround time for results from several weeks to two days. The POC pathway demonstrated a lower cost per correctly diagnosed case, largely due to reduced travel and sample transport expenses. Point-of-care haemoglobin electrophoresis represents a financially viable and more effective model for newborn SCD screening in remote, resource-limited African settings compared to centralised laboratory systems. National health policies in similar contexts should consider piloting and integrating POC devices into newborn screening programmes. Further research should evaluate long-term clinical outcomes and the feasibility of scale-up. sickle cell disease, newborn screening, point-of-care testing, haemoglobin electrophoresis, cost-effectiveness analysis, sub-Saharan Africa, health economics This study provides a practical, evidence-based economic analysis to inform the adoption of point-of-care diagnostic technologies for sickle cell disease in rural African health systems.