Category Archives: Maternal & Child Health

June 19th is #WorldSickleCellDay

Today (June 19th) is World Sickle Cell Day!  Every year, the international health community recognizes Sickle Cell Disease (SCD) as a debilitating genetic disease that impacts families across the globe. Keeping individuals and communities informed about the struggles that come with daily management of SCD, can help raise awareness as well as debunk stereotypes and stigmas associated with persons who have SCD.   

SCD affects millions of people worldwide and is particularly common among people originating from sub-Saharan Africa, Saudi Arabia, India, South America and Central America, and Mediterranean countries, such as Turkey, Greece and Italy.

SCD affects approximately 100,000 Americans and occurs in about 1 out of every 365 African-American births. Individuals living with SCD suffer from both acute and chronic complications that require frequent contact with the medical system. These complications include acute sickle cell pain, fever, and acute chest syndrome (ACS), which is the term used for a number of different findings that includes chest pain, cough, fever, hypoxia and new lung infiltrates.

Here are some quick facts about SCD:

  • Sickle Cell Disease is a group of inherited red blood cell disorders. The red blood cells become hard and sticky and look like a C-shaped farm tool called a “sickle” and the cells die early, which causes a constant storage of red blood cells. Healthy red blood cells are round and move through small blood vessels to carry oxygen to all parts of the body.
  • To get SCD, the trait must be inherited from both parents who already have the SCD trait. People with the trait usually do not have any of the signs of the disease and live a normal life, but they can pass the trait to their children.
  • SCD is diagnosed with a simple blood test.  It is most often found at birth during routine newborn screening tests. Early diagnosis and treatment are important.
  • There are several treatment options available for individuals living with different complications of SCD, but the only cure for SCD is a bone marrow or stem cell transplant.  Transplants are very risky, and can have serious side effects, including death.  For the transplant to work, the bone marrow must be a close match (usually a brother or sister). 

SCD and COVID-19

Amid the COVID-19 pandemic, there is significant concern that the overlap of lung disease from COVID-19 with ACS may result in increased complications and amplification of healthcare utilization among individuals with SCD. Patients with SCD often have underlying cardiopulmonary co-morbidities that may predispose them to poor outcomes if they become infected with COVID-19. Source: hematology.org. 

Below are recommendations from the Sickle Cell Disease Association of America (SCDAA) for patients with SCD regarding COVID-19:

  • Patients and parents should be educated about COVID-19 signs and symptoms and the importance of physical distancing to limit chances of exposure and infection.
  • Patients and parents should receive counseling to continue to monitor for fever or other signs of infection. Call  hospital, doctor, or nurse first for advice on where to go for an evaluation.
  • Be sure that patients have an ample supply of all prescribed medication at home (including analgesics) to manage both acute and chronic pain.
  • Patients should adhere closely to the correct use of medications.

SCD Partnerships

DHEC is committed to educating the community and public about the availability of resources and services for individuals and families living with sickle cell disease.  DHEC’s Division of Children and Youth with Special Health Care Needs (CYSHCN), provides assistance to persons with sickle cell disease by covering services, such as, medical expenses, physician visits, durable medical equipment, medical supplies, and prescription drugs.  Assistance is offered to both children and adults who meet eligibility requirements. 

Additionally, CYSHCN engages with the four Sickle Community Based Organizations in the state — the James R. Clark Memorial Sickle Cell Foundation, – Louvenia D. Barksdale Sickle Cell Anemia Foundation, – Orangeburg Area Sickle Cell Foundation and – COBRA Human Services Agency Sickle Cell Program – to ensure persons living with SCD have access to community resources and support services. 

Get Your Flu Shot During National Influenza Vaccination Week

This week is National Influenza Vaccination Week, and we are entering the peak of flu season. Receiving a flu vaccination can reduce flu illness, doctor’s visits, and missed work or school, as well as prevent flu-related hospitalizations.

Influenza (flu) is a contagious respiratory illness caused by influenza viruses that infect the nose, throat, and sometimes the lungs. According to the Centers for Disease Control and Prevention (CDC), it can cause mild to severe illness and at times can lead to death.

Everyone in your family who is six months and older should get a flu vaccine every year. Protect yourself and your loved ones by getting your shot today.

Flu symptoms may include:

  • fever,
  • cough,
  • sore throat,
  • runny or stuffy nose,
  • muscle or body aches,
  • headaches, and

Flu germs are spread by tiny droplets when people with flu cough, sneeze, or talk. Those droplets can land in the mouths or noses of people who are nearby.

Flu shots_SC Health Assessment

According to the 2018 South Carolina State Health Assessment, many South Carolinians are receiving their flu shots, even above the national average. During the 2016-17 flu season, South Carolina had the second highest percent of adults 18 years and older who received the flu vaccine among the southern states (45.2%). Be in that number and get your shot today. Pregnant women should especially speak to their doctor about flu vaccination, as they are at an increased risk for a severe case of the flu due to changes in their immune system, heart, and lungs during pregnancy. Flu can cause severe reactions to the mother as well present adverse outcomes for the infant.

DHEC offers the flu vaccine at all public health clinics. Find a clinic near you by visiting https://www.scdhec.gov/health/health-public-health-clinics.

Local Hospital Acknowledged by DHEC Newborn Screening Program for Becoming Champions of Satisfactory Dried Blood Spot Collection

Newborn screening is a state public health service intended to identify infants who may be at an increased risk of certain disorders. Many consider newborn screening the most successful public health program in the United States. The Centers for Disease Control and Prevention (CDC) listed newborn screening as one of the 10 great public health achievements of the last decade.*

The term “newborn screening” refers to the collective group of conditions screened at birth including dried blood spot, hearing, and Critical Congenital Heart Disease (CCHD). Our focus for this post is on Newborn Screening dried blood spots.

Every infant born in South Carolina is screened for unexpected medical conditions by collecting a blood sample, or blood spot specimen, from the infant’s heel 24 to 48 hours after birth. Five blood spots are obtained from approximately 57,000 infants born in South Carolina every year. Once dried and packaged, those blood spots are sent to the South Carolina Public Health Laboratory, where they are assessed for proper testing criteria also known as a satisfactory specimen collection.

If the laboratory deems the collection as unsatisfactory, those specimens are rejected, and the lab is unable to test for more than 50 disorders that are identifiable during the newborn period. Many of these disorders are time-critical or life-threatening. A repeat specimen is then requested, and a pediatrician, hospital, or health department is tasked with recollecting the specimen. This process can lead to a critical time delay of identifying an infant with a time critical disorder, timely diagnosis and treatment. Getting it right the first time, every time is important for all babies born in South Carolina.

 

In June 2019, the Newborn Screening Program, along with partners from the South Carolina Hospital Association (SCHA), traveled to McLeod Health Clarendon in Manning, SC. This recent visit was to recognize the hospital staff for achieving 100% satisfactory blood spot specimens in 2018. When the nurse manager, Debi, received a call from DHEC to acknowledge her facility’s accomplishment, she was pleasantly surprised. She revealed that her staff began to champion their newborn screening blood spot collection after attending the DHEC “First Time, Every Time” dried blood spot collection training workshop.

The processes implemented after the training guided them along a journey for success. Here is what Debi had to say: “I could not be prouder of my diligent and conscientious Women’s Services team at McLeod Health Clarendon; they truly exemplify our mission of providing excellence in healthcare! We would also like to thank the SC DHEC newborn screening team for making such a positive impact in the health care of all South Carolina newborns!” -Debi Love-Ballard, R.N., Director of McLeod Health Clarendon’s Women and Infant Services.

DHEC Group Pic for Newborn Screening Awards

McLeod Health Clarendon was the only South Carolina hospital to accomplish the goal of 100% satisfactory bloodspot specimen collection in 2018.  Approximately 400 infants received their results in a timely manner without experiencing a repeat collection process.

Congratulations McLeod Health Clarendon. Their impact on the babies born in their community is a true representation of DHEC’s vision of Healthy People, Healthy Communities in South Carolina.

For more information about newborn screening, visit https://scdhec.gov/health-professionals/lab-certification-services/newbornscreening and https://www.babysfirsttest.org/.

* Koppaka, R Ten great public health achievements – United States, 2001–2010. MMWR Morb Mortal Wkly. Rep. 2011;60(19):619–623

South Carolina Health at a Glance: Maternal and Infant Health

Our next installment of the 2018 Live Healthy State Health Assessment summaries covers maternal and infant health.  Because the document is 346 pages, we will summarize each section.  Check out our previous posts:  overview of the report, South Carolina demographics, leading causes of death and hospitalization, cross-cutting, and access to healthcare.

Infant Mortality

The five leading causes of infant death in South Carolina were:

  • Birth defects (85%)
  • Preterm birth and low birthweight (14.2%)
  • Unintentional injuries (9.7%)
  • Sudden Infant Death Syndrome (SIDS) (6.7%)
  • Maternal complication of pregnancy (5.0%).

Targeted education and interventions focused on infant death prevention and contributing factors helps to reach audiences in greatest need.  Although the infant mortality rate decreased from 8.5 deaths per 1,000 live births in 2007 to 7.0 deaths in 2016, this rate is higher than the national infant mortality rate and the Healthy People 2020 targeted goal.

Infant Mortality_SC Health Assessment

Birth Defects

Babies affected by birth defects are at an increased risk for long-term physical, cognitive, and social challenges.  Families affected by birth defects often deal with complex medical conditions that require surgery and early intervention services within the first three years of life.  Approximately 8,074 birth defects were reported in South Carolina from 2009-2015.  Birth defect types include:  cardiovascular, central nervous system, chromosomal, orofacial, musculoskeletal, renal, genital, gastrointestinal, limb defects, and eye and ear defects.

Strategies to prevent birth defects include maintaining a healthy diet and consuming at least 400 micrograms of folic acid daily, regularly visiting a healthcare provider for chronic disease management and infection prevention, and avoiding exposure to drugs and alcohol.

Preterm Birth

Preterm birth is the live birth of a baby before 37 weeks of pregnancy.  The earlier a baby is born, the greater the chances of having health problems in the short-term and long-term for the newborn.  These health problems can include respiratory distress, bleeding of the brain, anemia, or other health issues.

In 2016, preterm birth in South Carolina was higher than the United States.  The percent of preterm birth increased as the age of the mother increased.  Approximately 14.7% of non-Hispanic Black women experienced preterm births.

Preterm birth_SC Health assessment

Low Birthweight

Low birthweight is the birth of a baby weighing less than five pounds, eight ounces.  Although some low birthweight babies are healthy, others may require special care at birth due to respiratory distress, intestinal complications, bleeding of the brain, or other health problems.  Babies born at a low birthweight also have increased risk for developing chronic health conditions later in life.

Low Birthweight_SC Health Assessment

Teen Birth

The birth rate for teenagers aged 15 to 19 has continuously declined since 1991, reaching historic lows across the United States.  Success in the decline may be attributed to increased access to long-acting reversible contraception, delayed onset of sexual activity, and effective abstinence education.  Although the teen birth rate has declined significantly from 2007 to 2016, South Carolina’s teen birth rate is higher than national rate.

Teen birth_SC Health assessment

For more information about South Carolina maternal health statistics on Sudden Infant Death Syndrome (SIDS), intended pregnancy, prenatal care, breastfeeding, and pregnancy-related death, read the full Maternal and Infant Health chapter of the 2018 State Health Assessment.

 

Embrace All Aspects of Health During Women’s Health Week

How many times do we try to eat right, exercise, eliminate stress factors and get a good night’s sleep  with no success?  Well that stops this week!  May 12-18 is National Women’s Health Week.  Use this week to start a routine to keep your mind, body and spirit healthy.

CDC Women Exercise Class Photo

According to the Centers for Disease Control and Prevention (CDC), taking these steps can lead to better health:

 

By the Numbers

According to the 2018 South Carolina Health Assessment, here are some health findings about women in South Carolina.  Read the full assessment for more statistics.

  • The prevalence of South Carolina women delaying medical care due to cost was higher than South Carolina males.
  • Non-Hispanic Black women experienced a higher rate of new cases of late-stage breast cancer than non-Hispanic White women. South Carolina ranks 19th in the nation for new cases of breast cancer.  White women are diagnosed at a higher rate than Black women; however, Black women die at a higher rate (almost 50% higher).  In 2015, there was a total of 4,077 new cases of breast cancer, of these, 1,306 were diagnosed as late-stage.
  • In 2016, 75% of South Carolina women aged 50 to 74 years old received a mammogram within the last two years.
  • South Carolina ranks 19th in the nation for new cases of cervical cancer. Black women are diagnosed at a higher rate than White women and also die at a higher rate.  There were 216 new cases of invasive cervical cancer in 2015.
  • In 2016, approximately 90% of women aged 21 to 65 years old reported having a Pap smear within the past three years.
  • Every year, more than 195,000 women in South Carolina are victimized by sexual violence, physical violence and/or stalking by an intimate partner.

If you are not as healthy as you would like to be at your current age, it is never too late to start!  View the Healthy Living by Age page to gauge your health from ages 20s-90s.  Think you’ve got your health covered?  Find out your health score.