Cuban programme for prevention of sickle cell disease.

The percentage of carriers of the sickle cell gene in Cuba ranges from 3 to 7% in different regions. In 1983 the National Medical Genetics Centre initiated a programme for the control of sickle cell disease, which was started in Havana and later extended nationwide. The programme is based on mass education, screening and supportive genetic counselling, care of affected individuals, and availability of prenatal diagnosis. 806,935 pregnant women had been screened by the end of 1989: 29,913 (3.7%) were heterozygous, homozygous or doubly heterozygous for abnormal haemoglobin. 19,686 fathers (67%) were also tested: 1268 at-risk couples were detected. 531 elected to have prenatal diagnosis; 404 results were obtained and 98 affected fetuses (SS or SC) found. In 72 cases the pregnancy was terminated.