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Leiden University Medical Center On-site testing prevents Rhesus Disease in Africa

There are serious risks for an unborn child with a different blood type from its mother. Sometimes, the mother rejects the child, so to speak. In the Netherlands, it has become a rare disease. However, worldwide in low-income countries, 160,000 children die annually at birth.

Does the mother have a negative Rhesus blood type while her unborn child is Rh-positive. In such cases, a mother will sometimes produce antibodies in response to the “foreign” blood of the fetus, destroying the baby’s blood cells. Through simple treatment, the so-called Rhesus disease has now become very rare in the Netherlands. Gynecology-perinatologist Joanne Verweij of Leiden University Medical Center (LUMC): ‘It’s a bizarre flaw in nature that the immune system could attack one’s unborn child. These days, we can usually anticipate the problem through a timely blood group check of both the mother and child.’

Taboo and ignorance

LUMC is the worldwide center of expertise on Rhesus Disease. Approximately 160,000 children in low-income countries continue to die from it each year. An additional 100,000 children become severely disabled. In these countries, it’s not just the cost of treatment – between €40 and €80 – that is a problem. When a woman loses her babies repeatedly, she is often met with taboo and ignorance. Even though there is so much that we can do about it with proper screening and treatment, says Verweij. ‘As the center of expertise, for us, there is a great responsibility to share our knowledge and experience with other parts of the world.’

Domino effect

With funding from Dioraphte, LUMC will work together with Sanquin to increase knowledge and awareness in Ethiopia, Tanzania and Malawi. The goal: to establish local programs to prevent Rhesus Disease. Verweij: ‘My colleague Thomas van den Akker, Professor of Global Maternal Health, has already gained a lot of experience in Africa with projects about maternal mortality. The best place to start is where a network has already been established. We will be working in Ethiopia and Tanzania with local PhD students to ensure that the knowledge will be retained in the countries concerned. And in Malawi we are taking the initial steps toward establishing a similar research program. We are hoping for a domino effect. So that other African countries that learn from this experience, can establish their own programs.’

Stories from the field

Our aim is also to influence policy in the project countries. Verweij: ‘Through knowledge and data, we would like to demonstrate to health ministries the extent of the problem. It is more than just scientific data. We also document the experience of pregnant women and health care providers. We include their stories during these conversations.’ The key factor behind the screening process is a simple determinant for blood type that does not require any laboratory resources. Verweij: ‘We use a test approved by the World Health Organization. This means that we can quickly identify which women need preventive treatment.’

Donation as a catalyst

Verweij is excited about the commitment from Dioraphte: ‘They jumped on board before our proposal was even fully fleshed out. At that stage, the project was mainly a dream and a story about what we wanted to achieve. Dioraphte accepted, and that was an important catalyst. Since then, other funders have also latched on to us. Now, with an increasing number of people onboard, we can really move forwards.’