SCREENING FOR SICKLE-CELL TRAIT IN THE EMERGENCY DEPARTMENT

Objective: To determine: 1) whether young adult black patients in an e mergency department (ED) arc familiar with sickle-cell anemia and 2) h ow many of these patients know their own sickle-cell trait status. Des ign: Black patients in an ED were interviewed. Women aged 18 to 40 yea rs and men aged 18 to 50 were included. Sickle-cell screening was offe red to the patients. Setting: The ED of a large urban university hospi tal with an annual census of 50,000, approximately 25% of whom are bla ck. Patients: A convenience sample of 147 black patients presenting to the ED with minor medical conditions. Interventions: The subjects wer e interviewed to determine their knowledge base regarding sickle-cell anemia and to determine how many knew their sickle-cell trait status. The subjects were tested for sickle-cell trait. Measurements and main results: 98% of the patients had heard of sickle-cell anemia and 73% k new that it was a genetic disorder. Only 31% of the patients knew thei r sickle-cell status. Women were more likely than mn to know their sta tus. Approximately half of the patients who had family histories of th e trait or the disease knew their own status. Two of the 47 patients ( 4% ) tested had positive sickle-cell screen results. Conclusions: Most black patients of childbearing age presenting to the ED have heard of sickle-cell anemia and know that it runs in families, but few know th eir own trait status. Until access to primary care providers is improv ed, ED physicians who care for patients at risk for sickle-cell trait have an obligation to ask them about prior screening and either screen them or refer them for screening.