Abstract
ABSTRACTObjective: To use the spatial distribution of the sickle cell trait (SCT) to analyze the frequency of hemoglobin S (HbS) carriers in Sergipe.Methods: The sample consisted of all individuals born in Sergipe from October 2011 to October 2012 who underwent neonatal screening in the public health system. Tests were carried out in basic health units and forwarded to the University Hospital laboratory, where they were analyzed. We used spatial autocorrelation (Moran’s index) to assess the spatial distribution of heterozygous individuals with hemoglobinopathies.Results: Among 32,906 newborns, 1,202 showed other types of hemoglobin besides Hemoglobin A. We found a positive correlation between the percentage of black and multiracial people and the incidence of SCT. Most SCT cases occurred in the cities of Aracaju (n=273; 22.7%), Nossa Senhora do Socorro (n=102; 8.4%), São Cristóvão (n=58; 4.8%), Itabaiana (n=39; 4.2%), Lagarto (n=37; 4.01%), and Estância (n=46; 4.9%).Conclusions: The spatial distribution analysis identified regions in the state with a high frequency of HbS carriers. This information is important health care planning. This method can be applied to detect other places that need health units to guide and care for sickle cell disease patients and their families.
Highlights
Sickle cell anemia (SCA) is the most common monogenic disease in the world and is associated with mutant hemoglobin (HbS), which forms polymers in the red blood cells of patients, leading to chronic anemia
The high prevalence of sickle cell disease (SCD) in those regions can be historically explained by the forced migration of individuals brought to Brazil as slaves from Africa during the colonial period, mainly for working in sugar cane plantations in the Northeast and gold mines in the Southeast.[4]
This study aimed to describe the spatial distribution of individuals with HbAS sickle cell trait (SCT) by using data from the Newborn Screening Program (NSP) for hemoglobinopathies in the state of Sergipe, Northeastern Brazil
Summary
Sickle cell anemia (SCA) is the most common monogenic disease in the world and is associated with mutant hemoglobin (HbS), which forms polymers in the red blood cells of patients, leading to chronic anemia. SCA is endemic in many regions where malaria is or was prevalent due to the protective nature of the carrier state[1] and where the proportion of African descendants is higher.[2] Throughout the American Continent, the distribution of HbS — more prevalent in populations along the eastern coast — closely matches the distribution of people of African descent.[3]. In Brazil, SCA is more prevalent in the Northeast and three states of the Southeast region — São Paulo, Rio de Janeiro, and Minas Gerais. The high prevalence of sickle cell disease (SCD) in those regions can be historically explained by the forced migration of individuals brought to Brazil as slaves from Africa during the colonial period, mainly for working in sugar cane plantations in the Northeast and gold mines in the Southeast.[4]
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