Published in PLOS One on 2026-06-04, this study is presented as an attributed evidence briefing. The excerpts below are the original researchers’ words, reproduced under their Creative Commons Attribution licence. Health Signal has selected the abstract and, where needed, opening background paragraphs; the complete methods, results, limitations and references remain in the linked paper.
Original authors: Monalisa M. J. Faulkner, Fatima Jalloh, Foray Mohamed Foray, Sahr L. Gborie, Mohamed B. Jalloh
Source: PLOS One • DOI 10.1371/journal.pone.0350989
Read the complete primary study ↗ · Creative Commons Attribution licence
From the researchers
Abstract
Sickle cell disease is a major cause of childhood mortality in sub-Saharan Africa, yet country-specific burden estimates for high-prevalence settings in West Africa remain limited.
To describe Global Burden of Disease (GBD) 2023 modeled estimates of sickle cell disorders burden in Sierra Leone from 1990 through 2023, including temporal trends, age and sex patterns, and demographic contributors to mortality change.
We analyzed GBD 2023 modeled estimates for sickle cell disorders in Sierra Leone, including prevalence, deaths, years lived with disability (YLDs), years of life lost (YLLs), and disability-adjusted life-years (DALYs) as absolute counts and age-standardized rates. Temporal trends in age-standardized rates were assessed using log-linear regression. The Kitagawa-Das Gupta decomposition partitioned the change in estimated deaths into population growth, age-structure change, and age-specific mortality-rate changes.
Estimated prevalent cases increased from 48,689 (95% UI, 42,588−56,140) in 1990–90,498 (78,126−105,815) in 2023. Estimated deaths increased from 408 (288−579) to 635 (438−862), while the estimated age-standardized mortality rate declined from 10.2 to 7.9 per 100,000 (APC, −0.46%; 95% CI, −0.64 to −0.29). Decomposition attributed 159.6% of the net increase in deaths to population growth, −7.8% to age-structure change, and −51.8% to lower modeled age-specific rates. In 2023, an estimated 49.5% of deaths occurred before age 20. Point estimates suggested possible higher male mortality, but uncertainty intervals were wide and compatible with no clear sex difference.
GBD estimates suggest that Sierra Leone’s absolute burden of sickle cell disorders increased substantially between 1990 and 2023, while modeled rates declined. These modeled estimates highlight a growing absolute burden and persistent early-life mortality, supporting the need for improved surveillance, newborn screening, infection prophylaxis, hydroxyurea access, and longitudinal care systems.
Introduction
Sickle cell disorders (SCD) are common, severe inherited hemoglobin disorders and an important cause of premature death and disability worldwide [1–3]. Recent Global Burden of Disease (GBD) estimates showed that babies born with sickle cell disease increased from 453,000 in 2000–515,000 in 2021, while prevalent cases rose from 5.5 million to 7.7 million over the same period [1–3]. The term SCD here denotes the GBD cause category, which includes sickle cell anemia (HbSS), sickle-hemoglobin C disease (HbSC), and sickle-beta-thalassemia (HbS/beta-thalassemia). Sickle cell disease is used when referring more broadly to clinical services, care delivery, and intervention evidence. Sub-Saharan Africa (SSA) bears the greatest burden of sickle cell disease. A recent systematic review and modelling analysis estimated prevalence at 1.54% in infants, 1.51% in children younger than 5 years, and 1.78% in those younger than 15 years, corresponding in 2023 to 1.2 million, 2.8 million, and 8.9 million affected children, respectively [4]. Burden was highest in west and central Africa, with west Africa contributing the largest number of paediatric cases [4].
Reading this evidence
Use the full paper to check the study design, participant selection, comparator and outcome definitions before drawing a practical conclusion. An association does not by itself show cause and effect. A reported performance measure needs its denominator and uncertainty. A finding from a particular facility, sample or time period should retain that scope when it is discussed elsewhere.
This briefing makes the source accessible within the wider public health desk. It does not assess an individual patient or certify a product. When considering relevance to another health system, examine the original authors’ account of context and limitations, then seek local implementation evidence. The related reporting below provides other studies to read alongside this one; it is a topic connection, rather than a claim that their results are directly comparable.
© 2026 Monalisa M. J. Faulkner, Fatima Jalloh, Foray Mohamed Foray, Sahr L. Gborie, Mohamed B. Jalloh. Excerpts reproduced under CC BY. Selection, formatting and contextual notes by Health Signal. The researchers are the authors of the source study, not members of Health Signal’s staff.
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