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Mass Screens for Sickle Cell Disease

Ralph E. Bernstein, MB, FRC Path
JAMA. 1973;223(4):438-439. doi:10.1001/jama.1973.03220040052016.
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To the Editor.—  The EDITORIAL by Nalbandian (221:500, 1972) on the consequences of the passage of the National Sickle Cell Anemia Control Act calls for some comment and qualification—both with regard to the screening program introduced by the Grand Rapids group in its general applicability to the United States and to other parts of the world, where sickle hemoglobin attains notable incidences. The sickle cell phenomenon is not exclusive to 22 million black Americans; not only are there higher incidences among the Negroes of central equatorial Africa, the west coast bulge of Africa, the West Indies, and adjacent areas of South America, but sickle cell hemoglobin occurs to a variable, but often significant degree in non-Negroid groups, ie, Greeks, Italians, Sardinians, Turks, Libyans, and Tunisians of the Mediterranean regions, as well as inhabitants of South Arabia, Southeast Asia, India, Malagasy (originally Indonesian in origin, but with some Negroid admixture from


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