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November 24, 1975, Vol 234, No. 8 >
ARTICLE | November 24, 1975

Mass Screening for Sickle Cell Hemoglobin: Title and subTitle BreakIs There an Optimal Method? FREE

Robert M. Nalbandian, MDCOL ; Frank R. Camp, Jr, MSC; Raymond L. Henry, PhDCOL ; Nicholas F. Conte, MC
[+] Author Affiliations

The opinions or assertions contained herein are the private views of the authors and are not to be construed as official or as reflecting the views of the Department of the Army or the Department of Defense.

Reprint requests to Department of Pathology, Blodgett Memorial Hospital, Grand Rapids, MI 49506 (Dr Nalbandian).


JAMA. 1975;234(8):832-835. doi:10.1001/jama.1975.03260210040020
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References

The problem of screening large civilian and military populations for sickle cell hemoglobin and related conditions has been approached recently by three distinct methods. One method specifies hemoglobin electrophoresis as the initial screening technique, followed by a solubility (dithionite) test when a (nonspecific) "S band" is noted. Another method requires the use of the automated dithionite test, followed, when positive, by hemoglobin electrophoresis. A third method is a dual, automated technique for detecting anemia or hemoglobin S or both in the initial screening study; hemoglobin electrophoresis studies are done when indicated. All three methods provide data suitable for accurate diagnosis and genetic counseling, but substantial variations in costs and redundancy of data are found among these methods. Because it gives the "biggest diagnostic bang for the buck," the third merits widespread adoption.

(JAMA 234:832-835, 1975)

REFERENCES

1 +
Schmidt RM:  Sickle cell screening, communication for general distribution. Atlanta, Center for Disease Control, 1972 . Read before the 11th biennial planning conference of the Association of State and Territorial Public Health Laboratory Directors, March 6-10, 1972 , Atlanta.
2 +
Schmidt RM:  Laboratory diagnosis of hemoglobinopathies . JAMA 224:1276-1280, 1973;.
3 +
Riley GB: Sickle cell screening, communication for general distribution . National Heart and Lung Institute, (Oct 1) , 1972;.
4 +
Barclay GPT, Huntsman RG, Robb A:  Population screening of young children for sickle cell anaemia in Zambia . Trans R Soc Trop Med Hyg 64:733-739, 1970;.
5 +
Barnes MG, Komarmy L, Novack AH:  A comprehensive screening program for hemoglobinopathies . JAMA 219:701-705, 1972;.
6 +
Hicks EJ, Griep JA, Nordschow CD:  Comparison of results for three methods of hemoglobin S identification . Clin Chem 19:533-535, 1973;.
7 +
Nalbandian RM, Nichols BM, Heustis AE, et al:  An automated mass screening program for sickle cell disease . JAMA 218:1680-1682, 1971;.
8 +
Nalbandian RM:  Mass screening programs for sickle cell hemoglobin . JAMA 221:500-502, 1972;.
9 +
Nalbandian RM, Camp FR Jr, Conte NF:  Automated mass screening for S hemoglobin: A rational method derived from molecular information . Health Serv Rep 88:165-173, 1973;.
10 +
Murayama M, Nalbandian RM: Sickle Cell Hemoglobin: Molecule to Man . Boston, Little, Brown & Co, 1973;.
11 +
Nalbandian RM, Nichols BM, Camp FR Jr, et al:  Automated dithionite test for rapid, inexpensive detection of hemoglobin S and non-S sickling hemoglobinopathies . Clin Chem 17:1033-1037, 1971;.
12 +
Huntsman RG, Barclay GPT, Canning DM, et al:  A rapid whole blood solubility test to differentiate the sickle-cell trait from sickle-cell anaemia . J Clin Pathol 23:781-783, 1970;.
13 +
Binder RA, Jones SR:  Prevalence and awareness of sickle cell hemoglobin in a military population: Determination by a rapid screening method . JAMA 214:909-911, 1970;.
14 +
Cook A, Raper AB:  The solubility test for Hb S: A cheap and rapid method . Med Lab Technol 28:373-376, 1971;.
15 +
Cawley LP:  A systemized laboratory program for identification of hemoglobin variance . Ann Lab Clin Sci 2:480-491, 1972;.
16 +
Diggs WW, Diggs LW:  Hospital detection of sickle cell disease . Hosp Prac 7:109-113, 1972;.
17 +
Unger KW:  Sickle cell disease: Experience in an industrial medical department . J Occup Med 14:908-910, 1972;.
18 +
Diggs LW:  Screening tests for sickle cell disease . Postgrad Med 51:277-280, 1972;.
19 +
Pearson HA, O'Brien RT:  Sickle cell testing programs . J Pediatr 81:1201-1204, 1972;.
20 +
Matusik JE, Powell JB, Gregory DM:  A mechanized screening program for sickling hemoglobins . Clin Chim Acta 39:15-20, 1972;.
21 +
Canning DM, Crane RS, Hunstman RG, et al:  An automated screening technique for the detection of sickle cell haemoglobin . J Clin Pathol 25:330-334, 1972;.
22 +
Moran TJ:  S hemoglobinopathy in a community hospital: Incidence and control . JAMA 219:204-205, 1972;.
23 +
Nagel RL, Bookchin RM:  Simplified automated solubility test for the detection of hemoglobin S applicable to mass screening . Am J Clin Pathol 59:300-305, 1973;.
24 +
Ludvigsen B, Smith AT:  Sickle cell screening: A study of methods , in Advances in Automated Analysis: Hematology . Tarrytown, NY, Mediad, 1973;, vol 3.
25 +
Uddin DE, Dickson LG, Brodine CE:  Screening of military recruits for hemoglobin variants . JAMA 227:1405-1407, 1974;.
26 +
The S-Hemoglobinopathies: An Evaluation of Their Status in the Armed Forces , Ad-Hoc Committee on S-hemoglobinopathies, Division of Medical Sciences. National Academy of Science-National Research Council, February 1973;.
27 +
 Hemoglobin, method N-18a , in Technicon Autoanalyzer Methodology . Tarrytown, NY, Technicon Instrument Corp, 1967;.
28 +
Bemis EL:  Sickle cell safari . Blood 42:147-149, 1973;.
29 +
Nalbandian RM (ed): Molecular Aspects of Sickle Cell Hemoglobin: Clinical Applications . Springfield, Ill, Charles C Thomas, Publisher, 1971;.
30 +
Weatherall DJ: The Thalassemia Syndromes . Philadelphia, FA Davis Co, 1965;.
31 +
Comings DE:  The hemoglobinopathies and thalassemia , in Goodman RM (ed): Genetic Disorders of Man . Boston, Little, Brown & Co, 1970;, chap 6.
32 +
Weatherall DJ, Clegg JB: The Thalassemia Syndromes , ed 2. Oxford, England, Blackwell Scientific Publications, 1972;.
33 +
Torlontano G, Tata A, Camagna A:  A rapid screening test for thalassaemic trait . Acta Haematol 48:234-238, 1972;.
34 +
Pearson HA, O'Brien RT, McIntosh S:  Screening for thalassemia trait by electronic measurement of mean corpuscular volume . N Engl J Med 288:351-353, 1973;.
35 +
McCurdy PR, Lorkin PA, Casey R, et al:  Hemoglobin S-G (S-D) syndrome . Am J Med 57:665-670, 1974;.

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1 +
Schmidt RM:  Sickle cell screening, communication for general distribution. Atlanta, Center for Disease Control, 1972 . Read before the 11th biennial planning conference of the Association of State and Territorial Public Health Laboratory Directors, March 6-10, 1972 , Atlanta.
2 +
Schmidt RM:  Laboratory diagnosis of hemoglobinopathies . JAMA 224:1276-1280, 1973;.
3 +
Riley GB: Sickle cell screening, communication for general distribution . National Heart and Lung Institute, (Oct 1) , 1972;.
4 +
Barclay GPT, Huntsman RG, Robb A:  Population screening of young children for sickle cell anaemia in Zambia . Trans R Soc Trop Med Hyg 64:733-739, 1970;.
5 +
Barnes MG, Komarmy L, Novack AH:  A comprehensive screening program for hemoglobinopathies . JAMA 219:701-705, 1972;.
6 +
Hicks EJ, Griep JA, Nordschow CD:  Comparison of results for three methods of hemoglobin S identification . Clin Chem 19:533-535, 1973;.
7 +
Nalbandian RM, Nichols BM, Heustis AE, et al:  An automated mass screening program for sickle cell disease . JAMA 218:1680-1682, 1971;.
8 +
Nalbandian RM:  Mass screening programs for sickle cell hemoglobin . JAMA 221:500-502, 1972;.
9 +
Nalbandian RM, Camp FR Jr, Conte NF:  Automated mass screening for S hemoglobin: A rational method derived from molecular information . Health Serv Rep 88:165-173, 1973;.
10 +
Murayama M, Nalbandian RM: Sickle Cell Hemoglobin: Molecule to Man . Boston, Little, Brown & Co, 1973;.
11 +
Nalbandian RM, Nichols BM, Camp FR Jr, et al:  Automated dithionite test for rapid, inexpensive detection of hemoglobin S and non-S sickling hemoglobinopathies . Clin Chem 17:1033-1037, 1971;.
12 +
Huntsman RG, Barclay GPT, Canning DM, et al:  A rapid whole blood solubility test to differentiate the sickle-cell trait from sickle-cell anaemia . J Clin Pathol 23:781-783, 1970;.
13 +
Binder RA, Jones SR:  Prevalence and awareness of sickle cell hemoglobin in a military population: Determination by a rapid screening method . JAMA 214:909-911, 1970;.
14 +
Cook A, Raper AB:  The solubility test for Hb S: A cheap and rapid method . Med Lab Technol 28:373-376, 1971;.
15 +
Cawley LP:  A systemized laboratory program for identification of hemoglobin variance . Ann Lab Clin Sci 2:480-491, 1972;.
16 +
Diggs WW, Diggs LW:  Hospital detection of sickle cell disease . Hosp Prac 7:109-113, 1972;.
17 +
Unger KW:  Sickle cell disease: Experience in an industrial medical department . J Occup Med 14:908-910, 1972;.
18 +
Diggs LW:  Screening tests for sickle cell disease . Postgrad Med 51:277-280, 1972;.
19 +
Pearson HA, O'Brien RT:  Sickle cell testing programs . J Pediatr 81:1201-1204, 1972;.
20 +
Matusik JE, Powell JB, Gregory DM:  A mechanized screening program for sickling hemoglobins . Clin Chim Acta 39:15-20, 1972;.
21 +
Canning DM, Crane RS, Hunstman RG, et al:  An automated screening technique for the detection of sickle cell haemoglobin . J Clin Pathol 25:330-334, 1972;.
22 +
Moran TJ:  S hemoglobinopathy in a community hospital: Incidence and control . JAMA 219:204-205, 1972;.
23 +
Nagel RL, Bookchin RM:  Simplified automated solubility test for the detection of hemoglobin S applicable to mass screening . Am J Clin Pathol 59:300-305, 1973;.
24 +
Ludvigsen B, Smith AT:  Sickle cell screening: A study of methods , in Advances in Automated Analysis: Hematology . Tarrytown, NY, Mediad, 1973;, vol 3.
25 +
Uddin DE, Dickson LG, Brodine CE:  Screening of military recruits for hemoglobin variants . JAMA 227:1405-1407, 1974;.
26 +
The S-Hemoglobinopathies: An Evaluation of Their Status in the Armed Forces , Ad-Hoc Committee on S-hemoglobinopathies, Division of Medical Sciences. National Academy of Science-National Research Council, February 1973;.
27 +
 Hemoglobin, method N-18a , in Technicon Autoanalyzer Methodology . Tarrytown, NY, Technicon Instrument Corp, 1967;.
28 +
Bemis EL:  Sickle cell safari . Blood 42:147-149, 1973;.
29 +
Nalbandian RM (ed): Molecular Aspects of Sickle Cell Hemoglobin: Clinical Applications . Springfield, Ill, Charles C Thomas, Publisher, 1971;.
30 +
Weatherall DJ: The Thalassemia Syndromes . Philadelphia, FA Davis Co, 1965;.
31 +
Comings DE:  The hemoglobinopathies and thalassemia , in Goodman RM (ed): Genetic Disorders of Man . Boston, Little, Brown & Co, 1970;, chap 6.
32 +
Weatherall DJ, Clegg JB: The Thalassemia Syndromes , ed 2. Oxford, England, Blackwell Scientific Publications, 1972;.
33 +
Torlontano G, Tata A, Camagna A:  A rapid screening test for thalassaemic trait . Acta Haematol 48:234-238, 1972;.
34 +
Pearson HA, O'Brien RT, McIntosh S:  Screening for thalassemia trait by electronic measurement of mean corpuscular volume . N Engl J Med 288:351-353, 1973;.
35 +
McCurdy PR, Lorkin PA, Casey R, et al:  Hemoglobin S-G (S-D) syndrome . Am J Med 57:665-670, 1974;.

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