Automated Mass Screening for S Hemoglobin: A Rational Method Derived from Molecular Information.
ARMY MEDICAL RESEARCH LAB FORT KNOX KY
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Mass screening programs, coupled with genetic counseling, hold the promise of the elimination of sickle cell disease, leaving successive generations of black Americans progressively healthier. A rational screening method must be based on an understanding of the principles and limitations of currently used diagnostic tests and an analytical appreciation of the molecular pathology of hemoglobin S. Initial screening of the population at risk is undertaken by the automated dithionite test and only positive specimens are further studied by hemoglobin electrophoresis. This two-phase technique yields all necessary and pertinent data for diagnosis and genetic counseling at the lowest possible cost. The principle of the dithionite test is based on the easy detection of hydrophobic-bond-dependent nematic liquid crystal systems formed by hemoglobin S. The automated dithionite test can process 960 whole blood specimens per technician-day at a reagent cost of 2 cents each. An accelerated version, currently in extended field trials, processes 1,200 whole blood specimens per technican-day at a reagent cost of 0.1 to 2 cents each. Modified author abstract
- Medicine and Medical Research