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Sickle cell anaemia
in India.

Sickle cell is often thought of as an African disease, but it is common in parts of India too, especially among tribal communities in central, western and southern India. Here's who carries it, how the test works, what the national mission is doing, and what it means for a couple.

By the DontMarryYourBro team · Updated November 2026 · 7 min read · How we fact-check

The short answer

  • Carriers: between 1% and 40% of people in different tribal communities carry the sickle gene. It is also found in some non-tribal communities.
  • Two carriers: each pregnancy has a 1 in 4 chance of sickle cell disease.
  • The national mission (launched July 2023) aims to screen 7 crore people up to age 40 in 17 states, and end sickle cell disease as a public health problem by 2047.
  • By July 2025, over 6 crore people had been screened, identifying about 2.15 lakh people with the disease and about 16.7 lakh carriers.

What sickle cell is

Sickle cell disease is an inherited blood disorder. A change in the hemoglobin gene (HbS) makes red cells stiff and curved like a sickle when oxygen is low. They block small blood vessels and break down early, causing anaemia, severe pain episodes, infections and, in some people, stroke or organ damage.

  • Sickle cell trait (one copy, HbAS): you're a carrier. Carriers are healthy and usually never know. What sickle cell trait means.
  • Sickle cell disease (two copies, HbSS, or HbS with another variant like beta thalassemia): the condition itself.

The form common in India often comes with higher levels of fetal hemoglobin (HbF), which can make the disease milder on average than in some other regions. It can still be severe, and many people in India are diagnosed late.

Where in India it's common

The sickle gene is widespread among tribal communities, with carrier rates ranging from about 1% to 40% between groups. It's most concentrated across central India (Madhya Pradesh, Chhattisgarh, eastern Maharashtra, Odisha and Jharkhand), parts of Gujarat and Rajasthan, and pockets of the south, such as the Nilgiri hills and Wayanad. It's also found in some non-tribal communities in these regions.

If your family comes from one of these areas, it's worth testing even if no one in the family has been diagnosed. Carriers have no symptoms, so the gene can pass quietly for generations.

The National Sickle Cell Anaemia Elimination Mission

Launched in July 2023, the mission aims to screen about 7 crore people aged up to 40 in 17 high-burden states, and to eliminate sickle cell disease as a public health problem by 2047. By July 2025, over 6 crore people had been screened, about 2.15 lakh had been diagnosed with the disease and about 16.7 lakh identified as carriers.

People who are screened get a card showing their sickle cell status, and counselors encourage couples to compare cards before marriage, much as families compare kundlis. Progress has been uneven between states, so if you haven't been screened, you can ask at a government health centre or get tested at a private lab.

The tests

TestWhat it does
Solubility testA cheap screen that shows whether HbS is present. It can't tell trait from disease, and needs confirming
Point-of-care rapid testsQuick card tests used in the mission. They can tell carriers from people with the disease
Hb HPLCConfirms the result and also shows beta-thalassemia trait, HbE and HbD. How to read an HPLC report
DNA testNames the exact variants. Used for testing a pregnancy

If you're testing before marriage, ask for Hb HPLC: one test covers sickle cell and thalassemia, the two that matter most for Indian couples.

What it means for a couple

Partner 1Partner 2Each pregnancy
Sickle cell traitNot a carrierNo sickle cell disease. 1 in 2 chance the child is a carrier
Sickle cell traitSickle cell trait1 in 4 chance of sickle cell disease
Sickle cell traitBeta-thalassemia trait1 in 4 chance of sickle beta-thalassemia

Two carriers can marry and have healthy children. Knowing in advance means you can see a genetic counselor, test a pregnancy early, or consider IVF with embryo testing. Try the carrier odds calculator.

Treatment

Early diagnosis, vaccinations, hydroxyurea and good follow-up care help many people with sickle cell disease live long, full lives. A bone marrow transplant can cure it in some children, and new gene therapies have been approved in some countries but are very expensive. Prevention through testing remains the most practical step for most families.

General information, not medical advice. Talk to a doctor about testing and treatment.

Sources

  1. Colah RB et al. Sickle cell disease in tribal populations in India. Indian J Med Res 141(5):509–515 (2015)
  2. All India Radio: Six crore screened under sickle cell mission, over 2 lakh diagnosed, 16 lakh carriers identified (July 2025)
  3. Medical Dialogues: India screens 5.72 crore people to fight sickle cell disease (June 2025)
  4. Modell B, Darlison M. Global epidemiology of haemoglobin disorders. Bulletin of the WHO (2008)

One test for sickle cell and thalassemia.

The couple check includes Hb HPLC for both of you, read together, with a doctor to explain what it means.

Request a couple check

Questions people ask.

Is sickle cell anaemia common in India?

Yes, in some regions. Among tribal communities, 1% to 40% of people carry the sickle gene depending on the group. It is most common in central India, parts of Gujarat and Rajasthan, and pockets of the south.

Which states have the most sickle cell disease in India?

It is concentrated in Madhya Pradesh, Chhattisgarh, Maharashtra, Odisha, Jharkhand and Gujarat, with pockets in Rajasthan, Tamil Nadu (the Nilgiris) and Kerala (Wayanad). The national mission covers 17 high-burden states.

Which test is used for sickle cell?

A solubility test or a rapid point-of-care test can screen for sickle cell. Hb HPLC confirms the result and also detects thalassemia trait, so it is the best single test for couples.

Can two sickle cell carriers marry?

Yes. Each pregnancy has a 1 in 4 chance of sickle cell disease, so couples should see a genetic counselor before pregnancy to understand options such as early prenatal testing or IVF with embryo testing.

Is sickle cell trait a disease?

No. People with sickle cell trait are carriers and are usually healthy. The trait matters mainly for their children, if their partner is also a carrier.

What is the National Sickle Cell Anaemia Elimination Mission?

A Government of India mission launched in July 2023 to screen about 7 crore people up to age 40 in 17 states, give them sickle cell status cards and counseling, and eliminate the disease as a public health problem by 2047.