Stability of Blood Samples for Sickle Cell Disease Detection: An Examination for Extended Storage Period

Introduction: Sickle Cell Disease (SCD) is particularly widespread among the tribal communities in India. Under the National Sickle Cell Elimination Program it is screened through Point-Of-Care (POC) tests at local centers, followed by HPLC confirmation at district hospitals. The transportation and storage of samples from remote areas frequently lead to delays in testing. Aim: To assess the stability of blood samples utilized for the identification of sickle cell disease, particularly examining how prolonged storage time influence SCD diagnosis. Methods: In an ICMR taskforce multicentric study, 8,385 cord blood samples were collected in EDTA tubes from public health facilities of various blocks in the Kandhamal district of Odisha. The samples were kept at 4-8°C and transported to the District Headquarter Hospital for HPLC analysis. Initial 300 samples underwent immediate POC testing using Hemotype SC and confirmatory molecular testing was performed for all HPLC-positive cases. Results: A total of 93 SCD-positive (HbSS) cases were detected through HPLC and validated via molecular analysis. 6 cases were tested ≤4 days and 87 cases were tested >4 days with a mean of 23.0 ± 13.4 days, and the samples remained viable for diagnosis for up to 61 days when kept refrigerated. Conclusion: Cord blood samples maintained at 4-8°C are stable for as long as 61 days without compromising SCD diagnosis, which facilitates sample transport and enhances the feasibility of large-scale screening in remote areas.