In the Caribbean, where the sickle cell gene is highly prevalent, sickle cell disease is the most frequent genetic disease and a major public health problem. Regionally, there is also a relatively high prevalence rate of genes responsible for thalassemia, particularly in countries that have many persons of Asian descent.
Sickle cell disease is a hereditary, genetic disease characterized by the predominance of haemoglobin S in red blood cells. An abnormality of the β-globin gene results in production of hemoglobin S rather than the usual haemoglobin A. Under certain conditions, haemoglobin S crystallizes, causing the formation of rigid and fragile red blood cells responsible for painful vascular occlusion and anemia. The disease is also characterized by many complications such as infections, stroke, priapism, leg ulcers and pulmonary complications.
Thalassemia is also hereditary. In this condition, synthesis of normal haemoglobin is absent or reduced, inducing various symptoms. The severe forms are accompanied by anemia and developmental disorders.
There are several forms of SCD. In the most common, an individual inherits a Hb S gene from both parents. Forms which combine sickle and thalassemia are also seen in the Caribbean.
Considering the large heterogeneity in sickle cell disease management, experts in sickle Cell disease from 11 countries in the Caribbean region (Bahamas, Barbados, Cuba, Dominica, Guadeloupe, French Guyana, Haiti, Jamaica, Martinique, Dominican Republic, Trinidad and Tobago) who met in Guadeloupe in 2006, decide to establish collaborations to harmonize the management and allow Caribbean patients to receive the available treatments.
This commitment gave birth to CAREST network which has got a legal recognition in January 2012 as an Association governed by the French law of 1 July 1901.