Validity of sickling test and peripheral blood film method for sickle cell disease screening in tertiary care hospital
Journal Title: Medpulse International Journal of Pathology - Year 2018, Vol 7, Issue 3
Abstract
Background: Sickle cell disease is one of the most common inherited monogenic disorders, accounting for about 70% of world’s major haemoglobinopathies. The sickle cell genes predominantly seen among the tribal population in India, many of whom live in remote hilly region. However improvements in early diagnosis and enhanced preventive care treatment in high resource countries has led to a dramatic improvement in childhood survival and increase in average life span of affected individuals methods including Hb electrophoresis IEF,HPLC and PCR are used to screen for haemoglobinopathies in some developed countries. This is impractical in resource constrained countries, like India due to high cost. However there are other affordable methods of varying reliability, ease of applicability andcost affordable for screening for SCD in developing countries. These include solubility and sickling test and PBS method. Materials and Methods: Sickling test was done using sodium metabisulphate method. Thin blood films, stained with Giemsa stain were examined by light microscopy (×100) Hb electrophoresis was done by the cellulose acetate membrane method at pH 9.2 Results: Sickling test had sensitivity 75.67% and specificity 88.49%. It had positive and negative predictive values 68.29%, 91.74% respectively. Diagnostic accuracy of sickling method was 85.0% with kappa score 0.62 Conclusion: Sickling would therefore be the most recommended test for screening for SCD patients in poor resource settings and using Hb electrophoresis as confirmatory method.
Authors and Affiliations
Shamili Moningi, Jogi Naidu P, Pramod Jaisingh Shinde, Rajasekhar S V R, Anupama Devi G, Gouthami B
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