Implementation of the newborn screening programme for sickle cell disease in England: results for 2003-2005.
OBJECTIVE
This paper reports early screening results from the newborn sickle cell disease screening programme recently implemented in England.


METHODS
England. Screening is offered at 5-8 days of age as part of the existing bloodspot test and offered to all babies irrespective of ethnicity.


METHODS
The laboratory methods recommended are high performance liquid chromatography (HPLC) and iso-electric focusing (IEF). Two methods of analysis must be applied to all screen positive results. The conditions screened for are:- Sickle cell anaemia (Hb SS), Hb SC disease, Hb S/beta-thalassaemia, Hb S/D(Punjab), Hb S/O(Arab), Hb S/HPFH. Carriers identified for the common haemoglobin variants are reported to parents and follow-up counselling is offered. A bespoke laboratory quality assurance programme has been established which has defined standards of satisfactory performance.


RESULTS
Provisional figures from the first seven months of screening (up to March 2004) 108,255 infants were screened gave a screen positive rate of 1:900 for these high prevalence areas and a carrier rate of 2.7%. Figures for 2004-2005 show about 250 significant screen positive results for sickle cell disorders and about 6,500 carriers were identified. The birth prevalence for screen positive results from 2004-05 is 1:1500. We estimate that when there is countrywide data, the national birth prevalence will be about 1:2000-1:2,500.


CONCLUSIONS
The results from the national newborn sickle cell screening programme in England-show that the sickle cell disorders are as common as cystic fibrosis (CF) in England, although the distribution of cases is concentrated in London and other urban areas. The findings and approach to implementation adopted in England may be of interest to other Western European countries with increasing rates of sickle cell disease who are considering such programmes and also to other developed countries.
Streetly
Allison
A
NHS Sickle Cell and Thalassaemia Screening Programme, Division of Health and Social Care Research, King's College London School of Medicine, 42 Weston Street, London, UK. allison.streetly@kcl.ac.uk
Clarke
Mary
M
Downing
Melanie
M
Farrar
Lisa
L
Foo
Ying
Y
Hall
Kate
K
Kemp
Helena
H
Newbold
Jane
J
Walsh
Paul
P
Yates
Jenny
J
Henthorn
Joan
J
D000755:Anemia, Sickle Cell / Q000097:blood / Q000175:diagnosis*; D002851:Chromatography, High Pressure Liquid; D004739:England; D006451:Hemoglobin, Sickle / Q000032:analysis; D006801:Humans; D007231:Infant, Newborn; D007525:Isoelectric Focusing; D015997:Neonatal Screening / Q000331:legislation & jurisprudence / Q000379:methods*
D006451:Hemoglobin, Sickle