After screening of the complete population in a certain geographic area why is it necessary to issued to 100% screened population, here are some points for consideration. 100% card distribution is model is being used in Gujrat, Orissa, CG, MP etc..
- Matching of the card:
Supposing a normal person wants to marry some other person without card they will not be able to do match making and there will be difficulty in probability calculation of disease being transmitted to the next generation.
- Stop Forgery:
If a person found to be positive destroys his card, he can declare himself/herself to be normal. Therefore, leaving no ambiguity all people should receive the card.
- Blood donation-save life:
Card contains the blood group and this is handy when in the local community someone requires to donate blood to save life.
- Avoid re-testing:
If a person is tested and card is not issued, he will be retested several times for detecting sickle cell in tribal predominant areas in several govt programs. Lay person doesn’t know he is being tested for what.
According to the NHM GUIDELINES FOR PREVENTION & MANAGEMENT OF HEMOGLOBINOPATHIES 2016 solubility test is merely a screening and suggestive tool with only 92% specificity. Which means 8-9 people in 100 screened population with get normal report even if they are sickle cell positive, unless they are tested with electrophoresis, HPOS or HPLC. Giving such false negative person a normal card will cause a huge mistake and will dent the control program.
- Illicit extra-marital relation:
Unprotected sex with sickle cell disease person can cause high-risk sickle cell disease pregnancy. Therefore, leaving no ambiguity all people should receive the card.