Strengthening Newborn Screening: A Pilot Health Program Management for Sickle Cell Disease in Côte d’Ivoire

Background The World Health Assembly (WHA) resolution urges African countries with a high burden of sickle cell anemia (SCA) to design and implement national programs emphasizing early identification through newborn screening (NBS) and prompt access to adequate preventive care. Despite this recommendation, NBS and early prophylactic interventions remain insufficiently implemented in many sub‐Saharan African countries. This pilot program aimed to establish and evaluate NBS for sickle cell disease (SCD) as a health intervention in Côte d’Ivoire, determine the birth prevalence of SCD, and assess the feasibility of linkage to comprehensive care. Methods We conducted a prospective, multicenter cross‐sectional study from June 2022 to December 2024. The study population included all women who delivered in five maternity hospitals and received pre‐ and post‐test counseling. Umbilical cord blood samples from all live newborns were screened using a rapid diagnostic test (RDT) (HemotypeSC). All positive RDT results were confirmed using reference capillary electrophoresis. Results A total of 6,337 newborns were screened using RDTs, of whom 825 (13.02%) had abnormal hemoglobin profiles (including 9.45% HbS and 3.57% HbC). Among the 825 RDT‐positive cases, only 506 newborns underwent confirmatory capillary electrophoresis. Confirmatory testing showed 84 (16.6%) with normal hemoglobin (HbAA); 112 (22.13%) with SCD—including 1.98% HbSS, 2.17% HbSC, 1.38% HbS/β 0 ‐thalassemia, and 16.60% HbS/β + ‐thalassemia; 217 (42.8%) with sickle cell trait (HbAS); and 93 (18.3%) with HbAC. Among the 112 infants confirmed with SCD, only 68 were successfully enrolled in comprehensive care services. Conclusions This study represents the first report of an NBS program for SCD implemented as a public health intervention in Côte d’Ivoire. The findings demonstrate that NBS is both necessary and feasible within the country. Low‐cost RDTs present a practical first‐line screening option but require confirmation with gold‐standard diagnostic tools such as capillary electrophoresis. Immediate linkage to comprehensive care for infants diagnosed with SCD remains a critical component of program success and warrants further strengthening.