Background: The first survey on sickle cell disease (SCD) done in Uganda in 1949, reported the district of Bundibugyo\r\nin Western Uganda to have the highest sickle cell trait (SCT) prevalence (45%). This is believed to be the highest in the\r\nwhole world. According to the same survey, the prevalence of SCT in the districts of Mbale and Sironko in the East was\r\n20-28%, whilst the districts of Mbarara and Ntungamo in the West had 1-5%. No follow-up surveys have been\r\nconducted over the past 60 years. SCA accounts for approximately 16.2% of all pediatric deaths in Uganda. The pattern\r\nof SCT inheritance, however, predicts likely changes in the prevalence and distribution of the SCT. The objective of the\r\nstudy therefore was to establish the current prevalence of the SCT in Uganda.\r\nMethods: This study was a cross sectional survey which was carried out in the districts of Mbale and Sironko in the\r\nEastern, Mbarara/Ntungamo and Bundibugyo in Western Uganda. The participants were children (6 months-5 yrs).\r\nBlood was collected from each subject and analyzed for hemoglobin S using cellulose acetate Hb electrophoresis.\r\nResults: The established prevalence of the SCT (As) in Eastern Uganda was 17.5% compared to 13.4% and 3% in\r\nBundibugyo and Mbarara/Ntungamo respectively. 1.7% of the children in Eastern Uganda tested positive for\r\nhaemoglobin ss relative to 3% in Bundibugyo, giving gene frequencies of 0.105 and 0.097 for the recessive gene\r\nrespectively. No ss was detected in Mbarara/Ntungamo.\r\nConclusions: A shift in the prevalence of the SCT and ss in Uganda is notable and may be explained by several\r\nbiological and social factors. This study offers some evidence for the possible outcome of intermarriages in reducing\r\nthe incidence of the SCT.
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