Performance of a dithionate solubility-based diagnostic test kit for sickle cell disease at Central Public Health Laboratories in Uganda
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Sickle cell disease refers to a group of red blood cell disorders in people with an abnormal hemoglobin. This is created by a single nucleotide substitution at the sixth codon in the gene for production of hemoglobin. Diagnosis is an important aspect in management of the disease. Because the national sickle cell program is available in Uganda where all infants and new borns are screened for the sickle cell, this study assessed the performance characteristics of the dithionate solubility-based sickle cell diagnostic test in Uganda such that it can be used for the adults in massive sickle cell camps. In this study, 2ml of whole blood were collected in 5ml EDTA vacutainer tubes from 200 participants randomly who attended the sickle cell outreach programs organized by CPHL between December 2018 to April 2019. The blood samples were transported on ice to the sickle cell laboratory where they were stored in a fridge at 40c until analysis. A parallel testing technique was used where samples were analyzed with both the dithionate solubility test kit and isoelectric focusing electrophoresis. The results indicated that the dithionate solubility test kit had a sensitivity and specificity of 91% and 100% respectively. The positive and negative predictive values were 100% and 98% respectively and this indicated that it is an excellent rapid diagnostic test in detecting the sickle hemoglobin in adults. As a result, these rapid diagnostic tests should be used in Uganda to ease diagnosis and lower incidence of sickle cell cases at large. More research should also be done to evaluate the different forms of RDTS and validate their accuracy in detecting various diseases apart from sickle cell.