Haemoglobin Structure, Sickle Cell Anemia, Thalassemia, and Public Health Challenges in Kenya: A Comprehensive Review

Abstract

Hemoglobinopathies such as sickle cell disease (SCD) and thalassemia are among the most common inherited disorders worldwide. They impose heavy health and socioeconomic burdens, especially in sub-Saharan Africa, where malaria endemicity drives their distribution. In Kenya, prevalence is highest in Western and coastal regions, but screening is limited, health infrastructure is weak, and cultural myths persist. This review synthesized evidence on hemoglobin structure and genetics, distribution of hemoglobinopathies in Kenya, particularly diagnostic approaches, management challenges, and strategic interventions in Western Kenya. A narrative review of peer-reviewed and gray literature (2015–2025) was conducted using major databases and institutional repositories. Search terms included “sickle cell anemia,” “thalassemia,” “hemoglobinopathies,” “Kenya,” and “sub-Saharan Africa.” Hemoglobinopathies cluster in malaria-endemic regions, particularly western Kenya, a region predominated by the Luo, Luhya, Teso, and Abagusii communities. Sickle cell disease is most common in these populations, while thalassemia remains less studied but increasingly reported. Diagnostic methods are largely limited to electrophoresis and high-performance liquid chromatography (HPLC) in a few centers. Key challenges include underfunding, limited political commitment, a shortage of hematologists, and cultural misconceptions that delay care. Hemoglobinopathies represent a serious but under-addressed public health threat in Kenya. Interventions such as newborn screening, genetic counseling, community education, specialist training, and investment in advanced diagnostics and therapies, including gene therapy, are urgently needed to reduce morbidity and mortality.