Incoming NCAA athletes must be tested for the presence of hemoglobin (Hb) S but the prevalence with positive sickle cell trait (SCT) status at Division I institutions and their prior knowledge of status is unknown.
PURPOSE: Determine the prevalence of athletes with SCT at a Division I university and describe their demographics, prior knowledge of status, and Hb profile.
METHODS: A retrospective chart review of the 2010/11-18/19 academic years at one university. Main outcome measures included: actual and expected prevalence of SCT positive athletes, sex, race, sport, prior knowledge of SCT status and family history, and Hb profile (HbA, HbA2, HbS, HbF, and HbC) proportions. Expected prevalence was calculated from CDC statistics and applied to the known athlete racial breakdown per year with Fisher’s Exact test utilized for comparison.
RESULTS: Twenty-six SCT positive athletes (6±1 per academic year) were identified, accounting for ~1% of the athlete population each year. The majority were Black/African-American (n=24, 92.31%) males (n=23, 88.46%). There were less SCT positive Black/African-American athletes than expected on average per year (4 vs 13, p=0.044). Football had the greater part (n=18, 69.23%) of SCT athletes followed by men’s track and field (n=3, 11.54%). Other sports included women’s track and field, volleyball, baseball, men’s basketball and cheerleading. Five athletes (19.23%) reported prior knowledge of their SCT status. Seven athletes (26.92%) reported a family history of SCT or sickle cell disease, three of which did not know their own status. One athlete provided a newborn screen. Results of Hb electrophoresis testing were available for 25 (96.15%) athletes. Average values for HbA, HbA2, HbS, HbF and HbC were 57.10±2.70%, 3.13±0.47%, 39.72±2.84%, 0.23±0.83% and 0.00±0.00%, respectively, excluding one unique case with 0.00% HbA, 1.40% HbA2, 59.70% HbS, 38.90% HbF and 0.00% HbC.
CONCLUSIONS: Athletes with SCT accounted for a small proportion of the athlete population at a Division I university and were lower than expected prevalence. The majority had no prior knowledge of personal or family history. Obtaining Hb profiles beyond solubility testing can provide health care providers with information that may affect clinical manifestation and management.