Prevalence of Abnormal Hemoglobins among Students in Bahrain: A Ten-Year Study

Background: Sickle cell disease (SCD) and thalassemia are common in the Arab countries. Objective: The aim of this study is to evaluate the prevalence of abnormal hemoglobin in secondary school students in Bahrain and to compare the prevalence rates from 1999-2008. Design: Prospective study. Setting: Hematology Laboratory at Salmaniya Medical Complex. Method: The students of the 11th grade (2nd grade in secondary schools), during 19992008 were screened. Hb Chromatography was done by HPLC. Informed consents were obtained from the parents. Result: Sixty thousand and four hundred twenty-four (60,424) students were screened. The most common type of hemoglobin was hemoglobin A, found in 50756 (84%) of the students. The second was Hb S, the average prevalence of SCD was 1.13%, sickle cell trait was seen (SCT) in 13.3%. SCT in 1999 was 13.81 and in 2008 it was 12.8. Hb D heterozygous was found in 306 (0.51%) of the screened individuals. Hb D homozygous was found in 17 (0.03%). Hb EA heterozygous was found in 84 (0.14%), while Hb E homozygous was found in 3 (0.005%) of the students. Conclusion: The prevalence of SCD among the age groups (16-18 years) revealed a significant decline during these ten years period P= .000. The continuation of the screening and education efforts might reduce the prevalence further, if not eliminate it. SCD in 2000 was 1.3 and in 2008 it was 0.81.