Managing the Incidence of Sickle Cell Anemia Through Genetic Counseling

Genetic counseling has long held promise as a means for controlling Tay-Sachs disease, thalassemia, sickle cell anemia, and a host of other untreatable genetic illnesses. This paper reports a study to investigate the long-term viability of genetic counseling as an alternative to searching for a cure for sickle cell anemia. The paper includes consideration of the relative lack of fitness of individuals with sickle cell anemia, the effect of mutation from normal to sickle hemoglobin, and the effect of interbreeding between the black and white races as well as the result of counseling specific proportions of the population with high risk rather than counseling everyone. The results project the theoretical rate of sickle cell anemia in the U.S. black population over the next 800 years, and are viewed qualitatively rather than as firm projections due to the preliminary nature of the counseling data and the simplifying assumptions of the model. They suggest that counseling programs can play a very large role in reducing the incidence of sickle cell anemia, even in the near future.