Abstract
Although sickling and solubility tests and peripheral blood film methods are today available for sickle cell disease screening in Uganda, their reliability and ease of applicability have not been determined. This study was therefore carried out to determine the reliability of sickling and solubility tests and peripheral blood film method for screening for SCD in Uganda. This was descriptive laboratory based study which was carried out at Makerere University College of Health Sciences. The 200 samples from children aged between 6 months and five years were independently analyzed using sickling and solubility tests and peripheral blood film method. Hemoglobin electrophoresis cellulose acetate was used as the gold standard. Sickling and solubility tests had sensitivities of 65.0% and 45.0%, respectively and peripheral film had 35.0%. Sickling, solubility and peripheral film had specificities of 95.6%, 90.0% and 96.7%, respectively. Sickling had diagnostic accuracy of 92.5%, solubility (85.5%) and peripheral film (90.5%). Sickling had a Cohen’s Kappa of 0.6, solubility 0.3 and peripheral film 0.4. Sickling test had turn around time (TAT) of 38 minutes, solubility 70 minutes and peripheral 44 minutes. In conclusion, the sickling test was more reliable and easier to perform than solubility test and peripheral blood film method. It would therefore be a recommended test for preliminary screening of children for SCD at district health centers IV and confirming only positives using hemoglobin electrophoresis.
Highlights
Methods including hemoglobin (Hb) electrophoresis, iso-electric focusing (IEF) and high performance liquid chromatography (HPLC) are today used to screen for haemoglobinopathies in some developed countries [5]
The study was conducted in the department of Pathology, Makerere University College of Health Sciences where approval of the study was made and Department of Clinical Chemistry, Mulago hospital Uganda where Hb electrophoresis analysis was performed on blood samples which were received from the study districts
Of the 200 blood samples included in the study, Hb electrophoresis detected 178 samples with Hb a known negative control (AA), 20 AS and 2 SS
Summary
Methods including hemoglobin (Hb) electrophoresis, iso-electric focusing (IEF) and high performance liquid chromatography (HPLC) are today used to screen for haemoglobinopathies in some developed countries [5]. There are other affordable methods of varying reliability, ease of applicability and cost available for early screening for SCD in low income countries. These include solubility and sickling tests and peripheral blood film method. A developing country such as Malawi has carried out reliability and cost benefit analysis studies [8], and has recommended appropriate haemoglobin methods for use at district health centers, none of these studies have been undertaken in Uganda. This study was conducted to evaluate the sensitivity, specificity and predictive values and ease of applicability of sickling and solubility tests and peripheral blood film method
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