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Nigeria accounts for more than 1.5 million children living with sickle cell disease, making it the country with the highest burden of the condition globally, according to a new international study published in The Lancet Child & Adolescent Health.
The study estimates that nearly nine million children across sub-Saharan Africa were living with sickle cell disease in 2023, including about 1.17 million infants and 2.75 million children under five years old, who are at the highest risk of early death without timely diagnosis and treatment.
Nigeria bears the largest share of this burden, with over 1.5 million affected children under the age of 15, far ahead of other high-prevalence countries such as the Democratic Republic of the Congo and Ethiopia. Researchers say the figures underline both the severity of the crisis in West Africa’s most populous nation and the opportunity for significant public health gains if early intervention systems are strengthened.
The study, led by Professor of Public Health at Teesside University in the United Kingdom and Director of the International Society of Global Health, Prof. Davies Adeloye, draws on data from 40 studies across 22 African countries. It is described as one of the most comprehensive efforts to date to map childhood sickle cell disease at country level.
According to experts, sickle cell disease is an inherited blood disorder present from birth, which can cause severe pain, anaemia, repeated infections and organ damage. However, experts note that many of the most serious complications and deaths are preventable with early diagnosis and access to basic, low-cost care, including newborn screening, penicillin prophylaxis, routine vaccinations, malaria prevention and the use of hydroxyurea.
Despite the availability of these interventions, access remains limited in many parts of Nigeria. As a result, many children are diagnosed only after life-threatening complications occur, while others are never diagnosed at all, contributing to high levels of preventable illness and early childhood mortality.
Adeloye said Nigeria now stands at the centre of the global sickle cell burden, but stressed that the situation is not without solutions. “We already know what works. Newborn screening and early treatment are effective, affordable, and can be delivered through existing health systems,” he said.
He added that prioritising sickle cell disease within national health planning and integrating care into routine maternal and child health services could save hundreds of thousands of young lives.
The researchers are calling for urgent action to expand newborn and early-childhood screening programmes, improve access to essential medicines and vaccines, and strengthen integration of sickle cell care within primary healthcare systems. They also recommend increased domestic funding alongside international support, as well as improved national data systems to track and respond to the disease more effectively.
The study concludes that even modest improvements in early detection and treatment in high-burden countries such as Nigeria could substantially reduce preventable deaths and transform survival outcomes for children affected by sickle cell disease across the region.
