Access to emergency departments for acute events and identification of sickle cell disease in refugees

Lucia De Franceschi, Caterina Lux, Frédéric B. Piel, Barbara Gianesin, Federico Bonetti, Maddalena Casale, Giovanna Graziadei, Roberto Lisi, Valeria Pinto, Maria Caterina Putti, Paolo Rigano, Rossellina Rosso, Giovanna Russo, Vincenzo Spadola, Claudio Pulvirenti, Monica Rizzi, Filippo Mazzi, Giovanbattista Ruffo and Gian Luca Forni

Article Figures & Data


  • Figure 1.

    Numbers and country of origin of refugees in Italy with new identified severe hemoglobinopathy. (A) Numbers of total refugees in Italy, refugees from the sub-Saharan area, and refugees from Syria in the period between 2014 and 2017. (B) Map showing the influxes of refugees identified with hemoglobinopathies (SCD or TDT) after their arrival in Italy between 2014 and 2017. Countries of origin are shown in dark gray. The number of refugees from a country is proportional to the width and saturation of each line. (C) Numbers of patients with hemoglobinopathies (SCD or TDT) differentiated by genotype, as a function of nationality.

  • Figure 2.

    In refugees, the identification of new patients with severe hemoglobinopathy might result from the intersection of patients with acute events and screening programs for individuals from endemic areas. (A) Type and frequency of acute and nonacute events in refugees allowing the identification of a severe hemoglobinopathy in Italy between 2014 and 2017. *Other includes cardiopathy (n = 1), seizures (n = 1), splenic infarction and thrombosis of central retinal vein (n = 1), left gonalgia in severe gonarthrosis and joint deformities in septic arthritis outcomes (n = 1), inconsolable crying of a baby (n = 1), and genetic counseling for the second pregnancy of a mother (n = 1). (B) Percentages or patients screened, in a second-level refugee center with the new point-of-care screening device, as a way of fast-tracking the individuals with SCD, differentiated by genotype, as a function of nationality.