To test or not: occurrence of sickle cell trait and assessment of the awareness toward its screening among patients attending Magale Health Center IV, Namisindwa District, Eastern Uganda

Abstract

PurposeTo evaluate the occurrence of sickle cell trait (SCT), assess patient awareness and evaluate the performance of a sickle cell hemoglobin-S (dithionate-qualitative solubility) point-of-care test among patients seeking care at Magale Health Center IV, Namisindwa District, Eastern Uganda.Materials and methodsWe conducted a cross sectional study, in which we consecutively enrolled participants aged ≥18 years at Magale Health Center IV. Four milliliters of EDTA blood were collected by venipuncture and screened for SCT using solubility testing, and confirmed with hemoglobin (Hb) electrophoresis at Central Public Health Laboratory (CPHL), Kampala, Uganda. A structured questionnaire was used to assess participants’ awareness of SCT. Data were presented as proportion, and measurements of diagnostic test performance were calculated.ResultsWe enrolled 242 participants, of these 58.7% (N = 142) were females. Their mean age was 26.4 years (range 18–49). Of the 242 participants, 11, who represent 4.5% (95% CI: 3.3–5.9), tested positive. The sensitivity, specificity, positive predictive value and negative predictive value of the rapid sickle cell test were 63.64%, 100%, 100% and 98.30%, respectively. There was knowledge gap regarding sickle cell awareness.ConclusionThe occurrence of SCT was high, and the point-of-care test showed a high diagnostic reliability. The risk of SCT is associated with genetic predisposition as indicated by Hb electrophoresis. Community sensitization is key to avert the associated risk of Hb defects.

Sickle Cell Disease in East African Countries: Prevalence, Complications and Management

“…Only one child was reported to have HbSS giving a prevalence of 0.24% [20]. In a hospital-based cross-sectional study conducted in Eastern Uganda in 2018, Mandu et al reported the prevalence of HbAS to be 4.5% among 242 adults of 18 to 49 years [21]. In the same year, Mpimbaza et al also reported mean prevalences of HbSS and HbAS to be 0.84% and 8.74% respectively, this was a case-control study of 975 children (6 months to less than 10 years) conducted in Jinja Hospital, Eastern Uganda [22].…”