Sickle Cell Screening in Adults: A Current Review of Point-of-Care Testing

Area of Science:

• Hematology
• Clinical Chemistry
• Laboratory Medicine

Background:

• The sickle cell solubility test (SCST) is widely used for screening hemoglobin S (HbS) in adult blood samples.
• This assay is valued for its low cost, speed, high sensitivity, and specificity.
• Despite its advantages, SCST cannot quantify HbS levels and necessitates confirmatory tests to differentiate sickle cell trait from sickle cell disease.

Purpose of the Study:

• To detail the current sensitivity, specificity, positive predictive value, and negative predictive value of the SCST for HbS detection.
• To review the clinical utility of the SCST as a laboratory measure.
• To briefly discuss emerging point-of-care techniques that address SCST limitations.

Main Methods:

• Review of existing literature and performance metrics for the sickle cell solubility test.
• Analysis of sensitivity, specificity, PPV, and NPV data for SCST.
• Exploration of clinical utility and comparison with novel point-of-care methods.

Main Results:

• SCST demonstrates high sensitivity and specificity for detecting HbS.
• The test is cost-effective and rapid, making it suitable for large-scale screening.
• Limitations include the inability to quantify HbS and distinguish between sickle cell trait and disease without further testing.

Conclusions:

• The SCST remains a valuable standard screening tool for HbS in various adult populations.
• Confirmatory testing is essential for accurate diagnosis and management of sickle cell disorders.
• New point-of-care technologies are being developed to enhance HbS screening capabilities.