Acceptability of neonatal sickle cell disease screening among parturient women at the Paul Moukambi Regional Hospital in rural Eastern Gabon, Central Africa

Neonatal screening and the effective management of sickle cell disease (SCD) are now well established in urban areas in some sub-Saharan African countries. The high rate of sickle cell trait in Koula-Moutou, Gabon, prompted an assessment of the psychoclinical context of the introduction of neonatal screening in this rural area in eastern Gabon. Interviews were conducted with 215 women from February to June 2016 in Maternity and Maternal Child Protection services at the Paul Moukambi Regional Hospital Center in Koula-Moutou. Few childbearing women knew about SCD (24%), very few (6%) knew their hemoglobin status and only 30% of parturient women authorized sampling for neonatal SCD screening. Young mothers aged 16-28 years (p=0.018) and those who were educated (p=0.002) were more likely to authorize neonatal blood screening. There was no association between acceptance of blood sampling and knowledge of SCD or the parturient woman's hemoglobin status. The barriers to acceptance for SCD neonatal diagnosis are related to the education and culture rather than the knowledge of this disease. Introduction of diagnosis in rural areas requires a team comprising a psychosocial worker and health workers known to the rural population, to remove inhibitions related to blood collection from newborn infants.