AN AUDIT OF SICKLE-CELL SCREENING IN A PEDIATRIC HOSPITAL POPULATION

Current UK guidelines for the detection of sickle cell disease (SSD) r ecommend pre-operative screening of patients of African or Afro-Caribb ean descent and of patients from the Middle East, South Italy, Greece and India. These recommendations have considerable cost implications f or the NHS We have undertaken a retrospective audit of the use of SSD screening in our own institution. Between January 1987 and August 1992 , 1305 patients under 15 years of age (mean 3.8 years) underwent scree ning for SSD. Surgical patients accounted for 1120 tests (85.8%). The majority of patients tested were of Asian descent (n = 955; 73%); only 350 (27%) were of African or Afro-Caribbean descent. Only four patien ts (0.3%) tested positive (all sickle cell trait); three of Afro-Carib bean descent and one from Bahrain. We conclude that, in our population , the incidence of HbS is low. Patients of African or Afro-Caribbean d escent should continue to be tested but a selective policy may be indi cated in other ethnic groups.