Sickle Cell Disease Epidemiology and Statistics in Tanzania

Sickle Cell Disease Epidemiology and Statistics in Tanzania

Host Institution: Muhimbili University of Health and Allied Sciences  (MUHAS)

Location: Dar Es Salaam

Supervisors: Dr Raphael Sangeda, Prof Julie Makani and Dr Bruno Mmbando at National Institute for Medical Research (NIMR)

Project Description

Sickle cell disease (SCD) encompasses a group of genetic blood disorders which have a high prevalence in Tanzania. The Muhimbili Sickle Cell Programme(SCP), led by Prof Julie Makani, is a wide ranging programme which spans the full spectrum of research from basic science through to clinical application.  The Muhimbili sickle cohort (MSC), established in 2003 and maintained since then, consists of approximately 10,000 patients in Dar es Salaam. The cohort has yielded detailed demographic, clinical, laboratory and physiological data as well as archived samples. Approximately 5,300 of patients in the cohort are confirmed SCD patients. SCP has an ongoing genome wide association study (GWAS) in collaboration with the Wellcome Trust Sanger Institute (WTSI) under which 2,379,855 markers from 1,952 individuals in the cohort were genotyped.

After discussion with the supervisors, the intern will contribute to one or both of the following projects.

  1. Clinical epidemiology of liver function tests in SCD patients.The liver can be affected by a number of complications caused by SCD or its treatment. To understand SCD GWAS results it is necessary to study the significant epidemiological differences in liver functions in SCD patients in both steady and non-steady states. The intern will extract and analyse relevant clinical and phenotypic data from the MSC-MySQL database.  The statistical analysis will include a variety of descriptive approaches and tests for association using the R statistical package.  The results of the study will contribute to guidance on the treatment of SCD patients and will be compiled into a paper for publication.  
  2. Loss to Follow-up Pattern of Patients Attending Sickle Cell Clinic

    Managing patients’ clinical follow-up is crucially important since frequent drop-out events disturb the fight against SCD complications. This study aims to describe the loss to follow-up (LTF) pattern among patients attending the Muhimbili hospital SCD clinic. It will use data from the cohort of patients attended the clinic between 2004 and 2016. Survival analysis techniques, both non-parametric methods (Kaplan-Meier estimator and Log-rank test) and semi-parametric method (Cox’s proportional hazard model), will be applied. The impact of LTF on haemoglobin concentration, red blood cell counts and white blood cell counts will be determined. The results of this study will impact on improving the health of SCD patients.

Applications for this internship should be submitted via the online application system, stating clearly the title of the internship.

Deadline for applications: December 31st, 2017 at 11:59 PM (EAT).

Any inquiries about these internships should be sent to: