Abstract
Background 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. Aim The aim of this study was to determine the prevalence of SCD and to assess the hemoglobin variants among patients attending Ho Teaching Hospital. Methods 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. Results 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 (P=0.006) and female (P=0.004) participants with SCD. Conclusion 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.
Highlights
It is estimated that one out of every three Ghanaians has hemoglobin genotype mutation. is change in genetic make-up may result in genotypes such as HbAS, HbSS, and HbSC
Prior to the data collection, the hemoglobin electrophoresis test in the laboratory during the period under review was found to be performed by using the DY-300 Electrophoresis Machine, Micromed, UK, using the alkaline cellulose acetate technique as described by Cheesbrough [16]. e parameters reviewed included sickling, hemoglobin (Hb) electrophoresis, and full blood count (FBC) test results of participants (SCA and other sickle cell disease (SCD) patients). e total record of patients reviewed for the study was 1523
Female population was generally higher in the years 2016 and 2017, except for 2018 where male proportion was larger. ere was no significant gender difference observed in the years considered for this study (P 0.604). e greater proportion, 30.1%, of the study participants were between 25 and 34 years
Summary
It is estimated that one out of every three Ghanaians has hemoglobin genotype mutation. is change in genetic make-up may result in genotypes such as HbAS, HbSS, and HbSC. E 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. E homozygous (SS) sickle hemoglobin variant due to its hemolytic effect is referred to as sickle cell anemia (SCA), which largely is the most commonly inherited genetic disorder in the world and the most common form of the sickle cell disease. Sickle cell disease is a genetic blood disorder affecting red blood cells, with a resulting high morbidity and mortality rates; the common forms of which are HbSS, HbSC, HbSD, HbSE, and HbS β°/β thalassemia [9,10]. In the Volta region of Ghana, there is paucity of data on the prevalence of the condition among occupants of the region
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