Burden of Sickle Cell Disease and Alpha‐Thalassemia among Young Children in Western Kenya

Background Although hemoglobinopathies such as sickle cell hemoglobin and alpha‐thalassemia are common in Africa, there are limited data on their prevalence or their contribution towards childhood anemia. Objective To determine the prevalence of hemoglobinopathies in preschool children in western Kenya and understand their contributions to anemia. Methods We conducted a cross‐sectional survey of 860 children aged 6–35 months randomly selected from 60 villages in western Kenya. Hemoglobin (Hb), ferritin, transferrin receptor, malaria, C‐reactive protein (CRP), retinol binding protein (RBP) and hemoglobin genotype were measured. Results Of 828 children with sufficient blood samples, 430 (51.9%) were negative for the ‐3.7kb alpha‐thalassaemia deletion while 319 (38.5%) were heterozygous, and 79 (9.5%) were homozygous. Sickle cell trait and disease were found in 134 (17.2%) and 14 (1.8%) of children, respectively. After excluding 607 children with malaria parasitemia, inflammation (CRP>10 mg/L), iron deficiency (iron stores<0), or vitamin A deficiency (RBP<0.7 mmol/L), there remained a significant difference in the prevalence of anemia among those without alpha‐thalassemia (36.6%), heterozygotes (44.3%), and homozygotes (67.9%, p=0.01). Conclusions Hemoglobinopathies are prevalent among pre‐school children in western Kenya and are an important contributor to anemia.