Clinical and Ethonological Significance of Sickle Cell Gene in the Great Lakes Region of East and Central Africa; Special Reference to Kenya

Abstract

Although the prevalence of sickle cell trait (SCT) in Kenya was known, the magnitude of sickle cell disease (SCD) was yet to be established. We performed a national survey in all hospitals from November 1987 to May 1990 and found 3605 cases with SCD. Age was recorded for 2821 patients. 77% of these patients were under 15 years of age. The oldest patient was a 50 year old female. The paediatric to adult ratio was 3:1. About 58.4% of the patients were Luo, 23.9% Luhya, 8.5% Mijikenda, 2.7% Giriama, 0.7% Kisii 0.7% Teso, 0.6% Taveta, 0.5% Kalenjin, 0.6% Arab-Negro mixture groups, and 0.2% Kamba. For 2.3% of the 3605 patients, no ethnic origin was traceable. The remaining 0.9% were non-Kenyans from Uganda and Tanzania and a low representation of Kenyans of Kikuyu, Somali, and Turkana origins. There was a discrepancy between SCT rate (SCTr) and SCD rate (SCDr). The Kambes of the Mijikenda group in the Coast Province had the highest SCTr of 35% but a SCDr not exceeding 8.5%, whereas the Luos with a SCTr of 28% had a SCDr of 58.4%. The Kisii with a SCTr of 3% had SCDr of 0.7% whereas the Kikuyu with SCTr's of 2% had SCDr's of 0.2%. There were reports of SCD in the Somali and Turkana, despite the fact that no SCT had been found previously.