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Sickle cell anemia affects millions of people throughout the world. It is particularly common among people whose ancestors come from Africa; Spanish speaking regions (South America, Cuba, Central America); Saudi Arabia; India; and Mediterranean countries, such as Turkey, Greece, and Italy. In the United States, most people who have sickle cell disease are African American. In Missouri, the disease occurs in approximately 1 in every 400 African-American births, and approximately 1 in 12 African Americans carry the sickle cell trait.