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\ p None B a = c @ = Z ?N*8 X" 1 Arial1 Arial1 Arial1 Arial1 Arial1 Arial1 Arial General ` Table_1 > Assumption Notes/LimitationsS W e a s s u m e d t h a t a l l e l e f r e q u e n c i e s w e r e c o n s t a n t o v e r t h e s t u d y p e r i o d ( 2 0 1 0 2 0 5 0 ) . 5 This is based on the slow kinetics of inherited disorders and on data from Jamaica [25], but it neglects the influence of population migrations because of their unpredictable nature. We have assumed the implementation of specific health interventions in 2015 to calculate the number of lives that could be saved. Although some countries are currently considering implementing specific interventions for SCA, it is impossible to predict when each country might implement such interventions and to which extent.L We assumed that overall trends in the burden of SCA were driven by newborns. Data on the prevalence of SCA in adults is very limited, both in high- and low-income countries. Moreover, few studies have investigated SCA survival in adults. We assumed that it is possible to reduce excess mortality in under-five children to zero in high-income countries and to 5% in low- and middle-income countries. This is based on data from large-scale studies conducted in the United States, the United Kingdom, and Jamaica, summarised in Quinn et al. [34].N We assumed that information on consanguinity was too crude to be incorporated.I There is currently no global and comprehensive database on consanguinity. We assumed that the implementation of specific interventions would lead to an immediate reduction of the excess mortality in newborns with SCA. This is supported by the proven efficacy of these interventions. Nevertheless, the rapidity with which they might be implemented may vary widely between countries. We assumed that focused care for children under 5 y would not detract from care for others, including parents and older patients with SCA.J In the short term, improving the health of children under 5 y with SCA would increase awareness about this disease, which would inevitably benefit adults and older patients with SCA. In the long term, early diagnosis and appropriate health care helps prevent many of the serious clinical complications observed in adults with SCA. We assumed that data on the costs of implementing specific health interventions were too limited, particularly in low- and middle-income countries, to be incorporated into this study. Although data on the costs of these health interventions are available from various high-income countries, we could not find any published study presenting such data for low- and middle-income countries.
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