During the past 12 years, our hemoglobin laboratories have screened blood samples from approximately 40,000 black Americans for the presence of abnormal hemoglobins (Hb). In addition, 2,305 subjects have been studied in three pilot screening and counseling surveys conducted by our Sickle Cell Center. A review of our experience indicates that comprehensive Hb analysis, beginning with Hb electrophoresis, is essential for developing an effective education and counseling program for sickle cell disorders. The 2,305 samples were analyzed by starch gel electrophoresis during a ten-day period; material and reagent costs were comparable with costs of other screening methods. Reporting of abnormal results, education, and counseling were found to be done effectively by specially trained social workers in the home environment of persons affected. A program for training volunteer counselors has been developed and the Sickle Cell Center has assisted peripheral communities in initiating their own screening and counseling programs.
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