Acceptability of newborn screening for sickle cell disease among post-natal mothers at Homa Bay County Referral Hospital, western Kenya

Abstract

Background Sickle cell disease (SCD) is a genetically inherited blood disorder that manifests early in life with resultant significant health complications. Globally, nearly three quarters of all affected babies are in sub-Saharan Africa. Early identification of babies with SCD through newborn screening (NBS) followed by early linkage to care is recommended. However, the program has not been widely adopted in the sub-Saharan Africa. Evidence on acceptability of NBS to scale up NBS program is scarce. This study assessed factors associated with acceptability of newborn screening among mothers of newborns delivered at Homa Bay County Teaching and Referral Hospital (HCTRH), western Kenya. Methods This study employed a cross-sectional design among postnatal mothers at HCTRH. A semi-structured questionnaire was used for data collection. Maternal sociodemographic characteristics, knowledge, and perception were assessed. Babies were also screened for SCD using Sickle SCAN point-of-care test. The acceptability was calculated as percentage of mothers accepting to have their babies screened. Data were analyzed using logistic regression to explore factors associated with acceptability of NBS. Results Ninety-four percent of mothers accepted NBS. Mother’s age and occupation were significantly associated with acceptability of NBS for SCD. Younger mothers (OR = 3.01;95%CI = 1.16–7.83; p = 0.024) and being a student (OR = 6.18; 95%CI = 1.18–32.22; p = 0.031) were significant at bivariate regression analysis. Only being a student (aOR = 25.02; 95% CI = 1.29-484.51; p = 0.033) was significant at multivariate logistic regression analysis. Male partner support was found to be a strong positive modifying factor (coef = 7.50; std error = 1.31;95%CI = 4.94–10.07; p < 0.001). Conclusion The observed high acceptability of NBS for SCD in this population is indicative of a tacit acceptance of NBS for SCD.This is especially among younger mothers, being modified by male partner influence. A high level acceptance is necessary for scaling up the NBS program.