Assessment of Burden of Sickle Cell Trait and Disease Among Tribal Students of South Rajasthan

Background: Sickle cell disease, an inherited disorder of erythrocytes, is highly prevalent among the tribal population of India. However, the disease has not been well-illustrated and as the tribal population in India is approximately 100 million, it is necessary to identify the magnitude and characteristics of this problem. Also, the prevalence of the disease is unknown among the 5 million people of tribal provinces of Rajasthan. In this study we intended to determine the prevalence and characteristics of sickle cell disorder among the tribal students of South Rajasthan. This is the first large scale study conducted among the tribal population in the state of Rajasthan. Methods: This cross sectional study was conducted in the Maa Badi and Hostel students of the five tribal sub-plan districts of Rajasthan. Maa Badi Centres are situated in every village and one hostel for every four to five villages. A total of 36,752 students were screened from 1,006 Maa Badi centres and 243 hostels. The screening was done by solubility test and electrophoresis was used for confirmation. Findings: The prevalence of sickle cell disorder among the tribal students is 5.8%. The prevalence of the heterozygous and homozygous conditions is 5.61% and 0.17% respectively. Among the five sub-plan districts, highest prevalence was seen in Sirohi District (10.5%) followed by Banswara (7.42%), Udaipur (6.53%), Pratapgarh (5.51%) and Dungarpur (1.89%). Among the four major tribes belonging to these districts, highest prevalence was recorded in Garasia tribes (13.81%). Interpretation: The study carried out for the first time among large number of students, significantly revealed the existence of problem of sickle cell disorder in this region and it is recommended that a structured screening programme targeting the entire tribal population with appropriate counseling as well as treatment is needed through existing health system. Funding Statement: This study was funded by Government of Rajasthan, India. Declaration of Interests: The authors declare no competing interests. Ethical Approval Statement: The study was approved by the Institutional Committee for Research on Human Subjects, Desert Medicine Research Centre (ICMR)”, written informed consent and assent were obtained from all participants and all investigations were conducted according to the principles expressed in the Declaration of Helsinki.