Awaitey Daniel Kpodji, Akorsu Elliot Elikplim, Allotey Emmanuel Allote, Kwasie David Annor, Kwadzokpui Precious Kwablah, Tawiah Philip Apraku, Amankwah Stephen Adomako, Abaka-Yawson Albert
Department of Medical Laboratory Sciences, School of Allied Health Sciences, University of Health and Allied Sciences, Ho, Ghana.
Blood Bank, Laboratory Department, Ho Teaching Hospital, Ho, Ghana.
Adv Hematol. 2020 Mar 21;2020:7369731. doi: 10.1155/2020/7369731. eCollection 2020.
It is estimated that one out of every three Ghanaians has hemoglobin genotype mutation. This change in genetic make-up may result in genotypes such as HbAS, HbSS, and HbSC. Many children in low- and middle-income countries die even before they are diagnosed with sickle cell disease (SCD). In Africa, there are limited data on the incidence and prevalence of SCD and the Volta region of Ghana is no exception.
The aim of this study was to determine the prevalence of SCD and to assess the hemoglobin variants among patients attending Ho Teaching Hospital.
A retrospective study design was used to extract information from the Hospital Administration and Management Systems (HAMS) on the hemoglobin electrophoresis results and corresponding full blood count results of the SCD and sickle cell anemia (SCA) patients as well as patients who were asked to do Hb electrophoresis irrespective of their sickling status. Data were collected for the period January 2016 to December 2018. Sickle cell disease status was determined using the Hb genotypes from the Hb electrophoresis results. The full blood count was used to categorize the severity of anemia based on the hemoglobin concentration in the SCA and SCD patients.
A total of 1,523 subjects were included in the study of which the prevalence for sickle cell disease was 16.7%. The SCD genotypes included HbS (6.2%), HbSC (7.9%), and HbSF (2.6%). Hemoglobin C disease (HbCC) constituted 0.3% out of the total prevalence of SCD. The prevalence of anemia was 99.2%, with the severest form in HbS. Also, majority of the SCD patients had severe anemia. Difference in the severity of anemia was found to be significant among both male (=0.006) and female (=0.004) participants with SCD.
Patients receiving health care at the Ho Teaching Hospital had different hemoglobin variants with HbAS recording the highest prevalence. The high incidence of hemoglobin AS implies the possibility of having an increased population of individuals with sickle cell disease in future if measures are not put in place to improve screening, counseling, and education of the public about the health threat SCD poses.
据估计，每三名加纳人中就有一人存在血红蛋白基因型突变。这种基因构成的变化可能导致诸如HbAS、HbSS和HbSC等基因型。许多低收入和中等收入国家的儿童甚至在被诊断出患有镰状细胞病（SCD）之前就死亡了。在非洲，关于SCD发病率和患病率的数据有限，加纳的沃尔特地区也不例外。
本研究的目的是确定SCD的患病率，并评估霍教学医院就诊患者中的血红蛋白变异情况。
采用回顾性研究设计，从医院行政管理系统（HAMS）中提取SCD和镰状细胞贫血（SCA）患者以及不论镰状化状态被要求进行血红蛋白电泳的患者的血红蛋白电泳结果和相应全血细胞计数结果的信息。收集2016年1月至2018年12月期间的数据。根据血红蛋白电泳结果中的Hb基因型确定镰状细胞病状态。根据SCA和SCD患者的血红蛋白浓度，用全血细胞计数对贫血严重程度进行分类。
共有1523名受试者纳入研究，其中镰状细胞病患病率为16.7%。SCD基因型包括HbS（6.2%）、HbSC（7.9%）和HbSF（2.6%）。血红蛋白C病（HbCC）占SCD总患病率的0.3%。贫血患病率为99.2%，以HbS型最为严重。此外，大多数SCD患者患有严重贫血。在患有SCD的男性（=0.006）和女性（=0.004）参与者中，贫血严重程度差异显著。
在霍教学医院接受医疗保健的患者有不同的血红蛋白变异型，其中HbAS患病率最高。血红蛋白AS的高发病率意味着，如果不采取措施改善筛查、咨询以及对公众进行关于SCD所构成健康威胁的教育，未来患镰状细胞病的个体数量可能会增加。
