VALIDITY OF THE SICKLING TEST & PERIPHERAL BLOOD SMEAR METHOD IN CENTRAL INDIA'S TRIBAL POPULATION FOR SICKLE CELL DISEASE SCREENING

Abstract

Background: One of the most prominent hereditary monogenic diseases is sickle cell disease, responsible for around 70 % of the major hemoglobinopathies in the world. The sickle cell genes are primarily seen in India's tribal population, many of whom live in remote hilly areas. In developing countries like India, there are affordable methods of varying reliability, ease of application & affordable costs for screening for Sickle Cell Disease. Solubility & sickling test & peripheral smear of blood include these.

Materials & Methods: The sickling test was performed using the meta-bisulphate sodium method. Light microscopy (x100) examined thin blood smears, stained with Giemsa stain. Hb electrophoresis was performed at pH 9.2 using the cellulose acetate membrane method.

Results: The sickling test had 75.34 percent sensitivity & 88.25 percent specificity. It had 68.58 percent & 91.37 percent positive & negative predictive values, respectively. With a kappa score of 0.68, the diagnostic precision of the sickling test was 85 per cent.

Conclusion: For Sickle Cell Disease patients in low resource settings & using Hb electrophoresis as a confirmatory tool, the Sickling test will therefore be the most recommended test for screening.

Keywords: HB electrophoresis, Peripheral blood smear (PBS), Sickling test, tribal population.