Home›Hematology› Systematic review reveals high prevalence of sickle cell disease across infants and youth in sub-Saharan Africa
Systematic review reveals high prevalence of sickle cell disease across infants and youth in sub-Saharan AfricaSickle cell disease affects nearly 2 percent of kids under 15 in sub-Saharan Africa
The Lancet. Child & adolescent healthPublished June 1, 2026Study authors: Adeloye Davies, Auta Asa, Ale Boni Maxime, Thompson Jacqueline Y, Rudan IgorPubMed ↗DOI ↗Editorial oversight: Dr. Amelia Tan, PhD · Internal Medicine & Chronic Disease
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Key Takeaway
High prevalence of sickle cell disease in sub-Saharan Africa demands urgent scaling of newborn screening, prophylaxis, and comprehensive care platforms.
This systematic review and modeling analysis synthesizes data from 40 studies contributing 71 prevalence datapoints across 22 countries in sub-Saharan Africa. The research focuses on sickle cell disease, a significant public health concern in the region. By aggregating existing evidence, the study provides a clearer picture of the disease's distribution among vulnerable populations.
The analysis indicates that the overall prevalence of all sickle cell diseases is 1.78% in children and adolescents younger than 15 years. Specifically, infants show a prevalence of 1.54%, while those under five years old have a rate of 1.51%. These figures represent a substantial burden affecting millions of individuals across the continent.
Further breakdown reveals specific hemoglobin variants, with HbSS affecting 0.80% of the youth population and HbSC affecting 0.33%. The study notes substantial heterogeneity and moderate quality in the included data, alongside gaps in reporting from many countries. Despite these limitations, the findings underscore the urgent necessity to scale up newborn screening, early childhood prophylaxis, and vaccination programs.
To address these challenges, comprehensive care within child health platforms must be strengthened. Enhanced surveillance is required to close existing evidence gaps and guide sustainable policy reforms. These actions are vital for improving outcomes and reducing the impact of sickle cell disease on children and adolescents in the region.
Sickle cell disease is a serious blood disorder that causes pain and organ damage. A new look at data from 22 countries in sub-Saharan Africa reveals how many children live with this condition. The study combined information from 40 different sources to get a clearer picture of the problem.
The numbers show that about 1.78 percent of children and adolescents under 15 have the disease. This means roughly 8.8 million kids in the region are affected. The rate is slightly higher in older children than in infants or toddlers under five. Specific types of the disease, like HbSS and HbSC, make up smaller parts of this total.
The researchers were honest about the limits of their work. Data gaps exist in many countries, and the quality of the studies varied. Still, the findings point to an urgent need to scale up newborn screening and early childhood care. Strengthening surveillance and closing evidence gaps can guide better policies to help these children thrive.
What this means for you:
About 1.78 percent of children under 15 in sub-Saharan Africa have sickle cell disease.
BACKGROUND: There is a scarcity of data reporting on the burden of sickle cell disease across many African settings, particularly among children, who have the highest risk of preventable morbidity and mortality in the absence of early diagnosis and care. We aimed to estimate the prevalence of sickle cell disease and the absolute number of paediatric cases in sub-Saharan Africa to inform policy and service responses.
METHODS: For this systematic review and modelling analysis, we searched MEDLINE, Embase, Global Health (CABI), and African Journals Online (AJOL) for studies published from Jan 1, 2000, to Sept 10, 2025, that reported the prevalence of sickle cell disease among children and adolescents younger than 15 years in sub-Saharan Africa. We pooled crude prevalence using random-effects meta-analysis. We then fitted a mixed-effects meta-regression for age band (infants [aged 0 to <12 months], children aged <5 years, children and adolescents aged <15 years), sickle cell disease phenotype (total sickle cell diseases, haemoglobin SS [HbSS], haemoglobin SC [HbSC], and other compound heterozygous variants), Socio-demographic Index (SDI), World Bank income group, and geographical coordinates (latitude, longitude, interaction), plus a country random intercept. Absolute cases for 2023 were derived with the UN World Population Prospects.
FINDINGS: 40 studies contributed 71 prevalence datapoints from 22 countries across all four subregions of sub-Saharan Africa. Estimated prevalence for all sickle cell diseases was 1·54% (95% CI 0·34-7·49) in infants, 1·51% (0·35-6·72) in children younger than 5 years, and 1·78% (0·21-12·09) in children and adolescents younger than 15 years. By haemoglobin phenotype, the prevalence of HbSS was 0·70% (0·15-3·44) in infants, 0·69% (0·17-2·80) in children younger than 5 years, and 0·80% (0·09-5·11) in children and adolescents younger than 15 years, while that of HbSC was 0·29% (0·06-1·46), 0·28% (0·05-1·50), and 0·33% (0·04-2·43) across the same age groups, respectively. Using UN 2023 population denominators, we estimated 1 165 800 (95% CI 260 600-5 662 100) cases in infants, 2 752 200 (632 700-12 253 200) cases in children younger than 5 years, and 8 854 800 (1 068 900-60 148 700) cases in children and adolescents younger than 15 years living with sickle cell disease in sub-Saharan Africa in 2023. Regional prevalence (children aged <5 years, all sickle cell diseases) was highest in central Africa (2·07% [95% CI 0·30-12·76]), followed by west, southern, and east Africa. The burden was concentrated in populous countries, particularly Nigeria, Ethiopia, and the Democratic Republic of the Congo. Study quality was moderate overall and heterogeneity was substantial.
INTERPRETATION: Despite data gaps in many countries, the burden of sickle cell disease, especially in west and central Africa, underscores the urgent need to scale up newborn and early childhood screening, prophylaxis, vaccination, and comprehensive care within child health platforms, alongside strengthened surveillance to close evidence gaps and guide sustainable policy reforms.
FUNDING: None.
