The Prevention of Rh Disease of Newborns in Pakistan

Rh disease, a condition caused by incompatibility between maternal and fetal blood, is a significant public health problem that causes fetal and neonatal death. Among surviving newborns, Rh disease can lead to severe jaundice, anemia, and brain damage. While Rh disease has been virtually eradicated in high-income countries, it remains a serious problem in low- and middle-income countries (LMIC) where proven prevention strategies have been challenging to implement. Each year Rh disease is responsible for about 41,000 stillbirths, 90,000 neonatal deaths, and 97,000 cases of severe jaundice of which at least 48,000 will suffer permanent brain damage. The emergence of easy-to-use, portable, and affordable technologies can bring Rh testing to LMICs for the first time and can lead to the global prevention of Rh disease. We will use an innovative point-of-care test for the determination of Rh blood group in pregnant women. The test uses a single drop of blood and yields a result in two minutes that can be interpreted using a smart-phone application. These features will allow the test to be performed by minimally trained health workers in rural settings. We will generate evidence of the feasibility in identifying Rh negative women and providing prophylaxis to prevent morbidity and mortality in newborns in rural Pakistan. These data will be used to scale up our technology in Pakistan and similar LMICs with the potential of eradicating Rh disease and its sequelae worldwide.