Sickle cell disease in the Caribbean: progress in newborn screening, clinical care, and research through collaboration

The Caribbean has the highest incidence of sickle cell disease outside of west Africa. The regional gene pool responsible for sickle cell disease is mostly of west African origin, but contributions from many countries and regions such as India, China, the Middle East, and Europe have also introduced genes for haemoglobin (Hb) S, Hb C, and β-thalassaemia. The region is very diverse, including English, Spanish, French, and Dutch speaking countries; overseas territories based on colonial countries; and widely varied income levels, with a gross domestic product per capita from US$86 568 in the Cayman Islands to US$1829 in Haiti (2021 World Bank data). Research in sickle cell disease was reported from the Caribbean as early as the 1950s. Since then, researchers and health-care providers have continued to undertake research and develop programmes to improve the lives of people living with sickle cell disease.