Pain is Subjective : A Mixed-Methods Study of Provider Attitudes and Practices Regarding Pain Management in Sickle Cell Disease Across Three Countries.

CONTEXT: Sickle cell disease (SCD), an autosomal recessive blood disorder, affects millions of people worldwide. Approximately 80% of all cases are located in Africa. OBJECTIVES: This cross-national, interdisciplinary, collaborative study investigated provider attitudes about, and practices for, managing (assessing and treating) SCD pain. METHODS: We conducted 111 quantitative surveys and 52 semistructured interviews with health-care providers caring for adults and/or children with SCD in Cameroon, Jamaica, and the U.S. RESULTS: Applying Haywood\u27s scale for assessing SCD provider attitudes, the Jamaica site scored lower on Negative Attitudes than the Cameroonian and U.S. sites (P = 0.03 and CONCLUSION: Overall, findings reveal that SCD provider attitudes toward their patients differed across sites, yet at all three sites, treating SCD pain is multidimensional

African Genomic Medicine Training Initiative (AGMT)

The aim of this Professional Development Course was to provide genomics and genetics education to Nurses, Medical Doctors and Pathologists/Medical Laboratory Scientists & Technicians based in Africa. This course was provided free of charge - there was no cost associated with hosting a classroom for AGMT_2022. Further, attendance for participants and volunteer staff must be completely free-of-charge. If classrooms have running costs, they need to find alternate ways to cover these costs.  AGMT was launched in May 2016, in Senegal, by a group of stakeholders from the H3Africa Consortium and the AfSHG. AGMT course has successfully delivered a genomic medicine course to Nurses in 2017 and 2019. The 2022 iteration will deliver a genomic medicine course not only to Nurses but to Medical Doctors, Pathologists/Medical Laboratory Scientists and Technicians. There is a continuous need for genomic medicine across Africa from various health professionals. AGMT is working towards meeting this demand and accommodating different health professionals in addition to the group that it is currently accommodating.  The 1st AGMT iteration was run in 2017 with 19 classrooms in 11 countries, 1 online class, 225 students registered! The 2nd iteration was run in 2019 with 22 classrooms in 13 countries, 1 online class, 294 students registered. The 3rd iteration was run in 2022 with 24 classrooms (1 face-to-face, 3 blended and 20 online) in 11 countries and more than 800 participants with 261 students officially passing the course.</p

The effects of old and recent migration waves in the distribution of HBB*S globin gene haplotypes

Abstract Sickle cell hemoglobin is the result of a mutation at the sixth amino acid position of the beta (&#946;) globin chain. The HBB*S gene is in linkage disequilibrium with five main haplotypes in the &#946;-globin-like gene cluster named according to their ethnic and geographic origins: Bantu (CAR), Benin (BEN), Senegal (SEN), Cameroon (CAM) and Arabian-Indian (ARAB). These haplotypes demonstrated that the sickle cell mutation arose independently at least five times in human history. The distribution of &#946;S haplotypes among Brazilian populations showed a predominance of the CAR haplotype. American populations were clustered in two groups defined by CAR or BEN haplotype frequencies. This scenario is compatible with historical records about the slave trade in the Americas. When all world populations where the sickle cell gene occurs were analyzed, three clusters were disclosed based on CAR, BEN or ARAB haplotype predominance. These patterns may change in the next decades due to recent migrations waves. Since these haplotypes show different clinical characteristics, these recent migrations events raise the necessity to develop optimized public health programs for sickle cell disease screening and management