Long-awaited guidelines to help family physicians and other primary care providers manage and address the health needs of Georgia’s large sickle cell disease (SCD) population were published in 2014’s landmark evidence report, “Evidence-Based Management of Sickle Cell Disease,” by the National Heart, Lung, and Blood Institute.
SCD is the most common disorder identified by newborn screening in Georgia with one in 1,000 Georgia newborns diagnosed with SCD. This statistic ranks our state as having one of the largest SCD populations in the nation.
The new evidence report, developed by an expert panel composed of health care professionals including family medicine, is an important resource to help SCD patients receive appropriate care by providing the best science-based recommendations to guide practice decisions.
SCD affects the hemoglobin, a protein enabling red blood cells to carry oxygen to all parts of the body. Healthy red blood cells are round and move easily through small blood vessels, but SCD some red blood cells to become hard, sticky and curved like a sickle. These cells can get stuck in blood vessels and block the normal flow of oxygen throughout the body, leading to a variety of health problems including pain, stroke and organ damage.
After a newborn screening confirms a SCD diagnosis, the Georgia Department of Public Health (DPH) has several care delivery options for family physicians to intervene early and treat this genetic disease before a health emergency occurs.
There are two major sites in Georgia for hemoglobin follow-up and care for infants and children with SCD:
1. The Aflac Cancer Center and Blood Disorders Center of Children’s Healthcare of Atlanta
is the largest comprehensive pediatric SCD program in the country, providing services at three hospital sites in Metro Atlanta. Services include 24-hour acute care, health maintenance services, genetic counseling, chronic transfusion services, and transcranial Doppler ultrasound testing for stroke prevention.
in Augusta provides sickle cell outreach clinics in the South Georgia cities of Albany, Dublin, Valdosta, and Waycross. Services include screening and confirmation testing for SCD and carriers, ambulatory care, collaborative care for surgical problems, referrals to other services, outpatient care of acute problems, and outpatient transfusion therapy.
An Augusta-based adult clinic is also available with outreach clinics located in Albany, Blackshear, Macon, Savannah, and Valdosta.
· The following clinics were identified in densely populated SCD areas by a collaborative project with the Centers for Disease Control and Prevention – Registry and Surveillance for Hemoglobinopathies (RuSH project). They are:
- Memorial Health Children’s Hospital Hematology Oncology Clinic, Savannah, GA
- Pediatric Hematology Oncology Clinic at The Medical Center, Columbus Regional Health, Columbus, GA
- Hope for Kids, the Hematology Oncology Place of Excellence, The Children’s Hospital at Navicent, Macon, GA
As a medical home, family physicians and staff have the opportunity to counsel potential parents about the risks of having a child with sickle cell disease based on the parents’ genotype.
For additional information, call the Georgia Newborn Screening Sickle Cell Follow-up Program at (404) 657- 4143 or the Sickle Cell Foundation of Georgia, Inc. at (404) 755-1641.