INTRODUCTION

Sickle cell disease, a genetic condition affecting 1 in every 150 births in Jamaica, results from the inheritance of an abnormal haemoglobin gene from both parents. These abnormal genes, which occur in 15% of the Jamaican population, can be Identification of carriers of these genes along with targeted counselling on their significance would empower carriers to select partners who would give them healthy children rather than risk having a child with sickle cell disease. This proposal seeks to provide genotype detection for senior school children and to determine whether this information reduces the births of babies with sickle cell disease. The lifetime medical costs of a patient with sickle cell disease exceed J$1 million, the projected costs of the screening program are J$5-6 million annually so if the project prevents 5-6 affected births, it will be financially self-sustaining.

MANCHESTER PARISH

Where is Manchester? It is a Parish in central Jamaica outlined in red below. The Parish capital is Mandeville, the area is 830 km2 and the population was 190,000 in the 2001 census. There are 15 secondary schools with 3,500-4,000 students in the 5th and 6th forms and 6,000 births occur annually at 3 institutions.