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Published on: February 23, 2014
Sickle cell trait, hemoglobin C trait, and invasive pneumococcal disease
Katherine A Poehling1, Laney S Light, Melissa Rhodes
1Department of aPediatrics, Wake Forest University Health Sciences, Winston-Salem, NC 27157, USA. kpoehlin@wfubmc.edu
Epidemiology (Cambridge, Mass.)
|March 12, 2010
Summary
Black children with sickle cell trait or hemoglobin C trait face a higher risk of invasive pneumococcal disease. This study investigated the link between these hemoglobin variants and disease incidence.
Area of Science:
- Pediatric infectious diseases
- Hematology
- Public health
Background:
- Historically, Black individuals have higher rates of invasive pneumococcal disease (IPD) than White individuals, with the cause remaining unclear.
- Sickle cell trait and hemoglobin C trait are more prevalent in Black populations.
Purpose of the Study:
- To investigate if sickle cell trait or hemoglobin C trait are independent risk factors for invasive pneumococcal disease in children.
- To compare IPD rates among children with and without these hemoglobin variants.
Main Methods:
- A cohort study of children born in Tennessee (1996-2003) enrolled in TennCare was conducted.
- Incidence rates of IPD were calculated by race/ethnicity and hemoglobin type before and after pneumococcal conjugate vaccine (PCV7) introduction.
- Poisson regression analyses compared IPD rates, controlling for demographic and clinical factors.
Main Results:
- Over 10 years, 415 IPD episodes occurred. Before PCV7, rates were significantly higher in Black children with sickle cell disease.
- Post-PCV7, IPD rates declined across all groups.
- Black children with sickle cell trait or hemoglobin C trait had significantly higher IPD rates (77% and 42% higher, respectively) compared to White children and Black children with normal hemoglobin.
Conclusions:
- Black children with sickle cell trait or hemoglobin C trait exhibit an elevated risk for invasive pneumococcal disease.
- These findings highlight the importance of considering hemoglobin variants in understanding IPD disparities.
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