An up-date on the prevalence of sickle cell trait in Eastern and Western Uganda.

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Date
2010Author
Okwi, A.L.
Byarugaba, Wilson
Ndugwa, Christopher M.
Parkes, Arthur
Ocaido, Michael
Tumwine, James K.
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Background: The first survey on sickle cell disease (SCD) done in Uganda in 1949, reported the district of Bundibugyo
in Western Uganda to have the highest sickle cell trait (SCT) prevalence (45%). This is believed to be the highest in the
whole world. According to the same survey, the prevalence of SCT in the districts of Mbale and Sironko in the East was
20-28%, whilst the districts of Mbarara and Ntungamo in the West had 1-5%. No follow-up surveys have been
conducted over the past 60 years. SCA accounts for approximately 16.2% of all pediatric deaths in Uganda. The pattern
of SCT inheritance, however, predicts likely changes in the prevalence and distribution of the SCT. The objective of the
study therefore was to establish the current prevalence of the SCT in Uganda.
Methods: This study was a cross sectional survey which was carried out in the districts of Mbale and Sironko in the
Eastern, Mbarara/Ntungamo and Bundibugyo in Western Uganda. The participants were children (6 months-5 yrs).
Blood was collected from each subject and analyzed for hemoglobin S using cellulose acetate Hb electrophoresis.
Results: The established prevalence of the SCT (As) in Eastern Uganda was 17.5% compared to 13.4% and 3% in
Bundibugyo and Mbarara/Ntungamo respectively. 1.7% of the children in Eastern Uganda tested positive for
haemoglobin ss relative to 3% in Bundibugyo, giving gene frequencies of 0.105 and 0.097 for the recessive gene
respectively. No ss was detected in Mbarara/Ntungamo.
Conclusions: A shift in the prevalence of the SCT and ss in Uganda is notable and may be explained by several
biological and social factors. This study offers some evidence for the possible outcome of intermarriages in reducing
the incidence of the SCT.