Patterns of attendance at Jamaican sickle cell clinics 1952 to 1981

The development of sickle cell clinics in Jamaica over a 30-year period is reviewed. The clinics are expanding almost exponentially, new cases of SS disease being recruited at approximately 150 per year and new cases of SC disease at approximately 60 per year. In the first 20 years, the median age of clinic attenders increased markedly but has remained stable since 1970. This stable age structure in the presence of an almost exponential rate of clinic expansion implies that the influx of young cases is balanced by the increasing age of existing clinic attenders. The pattern of new referrals has also changed to that of predominantly young patients, suggesting that the bulk of symptomatic older patients in the community have already been recruited into the clinic population.