THE VIRGINIAN-PILOT
Copyright (c) 1997, Landmark Communications, Inc.
DATE: Friday, January 3, 1997 TAG: 9701030472
SECTION: FRONT PAGE: A2 EDITION: FINAL
SOURCE: STAFF AND WIRE REPORT
DATELINE: WASHINGTON LENGTH: 72 lines
Young black children in Florida appear to die from sickle cell disease at double the national rate, while Virginia's death rate from the disease is among the lowest in the country, a federal scientist says in a new study.
The research, reported Thursday in the government journal Public Health Reports, was based solely on death certificates and thus could not explain the disparity between states. In contrast to Florida, death rates in Pennsylvania, Virginia and Maryland were strikingly lower than the national average.
One theory on Florida is that the state must struggle to reach at-risk immigrants, particularly Haitians, so they can get the daily antibiotic treatment needed to increase young children's chances of surviving the rare genetic disease.
``They probably have more recent immigrants than any other sickle-cell program in the country,'' said Dr. Kwaku Ohene-Frempong, medical director of the Sickle Cell Disease Association. ``The barriers to health care that new immigrants . . . have may actually be impeding the ability to get care.''
``It's reasonable for the people in Florida to be somewhat concerned,'' said the study's author, Dr. Harold Davis of the Food and Drug Administration. He also urged researchers to investigate sickle-cell programs in Pennsylvania and Maryland because ``you would think something must be going on right there.''
Sickle cell is an inherited disease that primarily afflicts black Americans, affecting about one in every 350 black newborns. Abnormally shaped red blood cells can become stuck inside their capillaries, causing severe pain. Children particularly are vulnerable to life-threatening infections and are prescribed daily antibiotics until age 5 to increase their survival chances.
Nationwide, more young children are surviving sickle cell, Davis found. He checked death certificates of black children ages 1 to 4 from 1968 to 1980 and again from 1981 to 1992. Mortality dropped 35 percent between the two time periods, to 6.8 deaths from sickle cell for every 1,000 ``person-years,'' a way to measure the time U.S. children lived with the disease.
But when Davis examined 18 states with the greatest number of young black children, he found startling differences.
From 1981 to 1992, Florida's children died from sickle cell at 2.4 times the national rate, or 16.2 deaths per 1,000 person-years.
In contrast, sickle-cell children in Pennsylvania had a 52 percent lower mortality rate than the nation, and Maryland reported a huge 88 percent lower rate.
Virginia's mortality rate also appeared 52 percent lower than the nation's, but Davis said that Virginia's figures were not as statistically sound as Pennsylvania's.
Dr. William C. Owen, who directs the sickle cell clinic at Children's Hospital of The King's Daughters in Norfolk, had no explanation for any ``statistical'' differences, but said the results of the study were ``good news'' for Virginia.
He attributed the state's low death rates to a statewide network of sickle-cell comprehensive care clinics, like the one at Children's Hospital, that stress prevention and education.
Virginia also screens every newborn for disease, something not every state does.
Davis' study could not explain the geographic disparities, and he cautioned that his findings must be verified.
Florida plans to immediately do just that.
``This is a serious situation,'' said state health officer Dr. Jim Howell. He cautioned that it was just a theory that reaching immigrants was the problem, but he added, ``We are going to fully investigate this.'' MEMO: This story was compiled from reports by The Associated Press and
staff writer Debra Gordon.
KEYWORDS: SICKE CELL DEATH RATE VIRGINIA