An audit of sickle cell screening in a paediatric hospital population

Current UK guidelines for the detection of sickle cell disease (SSD) recommend pre-operative screening of patients of African or Afro-Caribbean descent and of patients of Middle East, South Italy, Greece and India. These recommendations have considerable cost implication for the NHS. We have undertaken a retrospective audit of the use of SSD screening in our own institution. Between January 1987 and August 1992, 1305 patients under 15 years of age (mean 3.8 years) underwent screening for SSD. Surgical patients accounted for 1120 tests (85.8 percent). The majority of patients tested were of Asian descent (n = 995; 73 percent); only 350 (27 percent) were of African or Afro-Caribbean descent. Only four patients (0.3 percent) tested positive (all sickle cell trait): three of Afro-Caribbean descent and one from Bahrain. We conclude that, in our population, the incidence of Hbs is low. Patients of African or Afro-Caribbean descent should continue to be tested but a selective policy may be indicated in other ethnic groups (AU).