Sickle cell (HBS) is a blood genetic disorder with morbidity and mortality affecting large number of tribal population. Universal screening programs are still cost intensive. The present short communication is an attempt to provide an anthropological method for estimating HBS spread and identifying hot spot regions in Indian population to aid prevention. The Indian population is largely structured into four broad geographical-linguistic (GL) administrative categories, states. Each GL further divided into eco-cultural zones (ECZ), comprising 3-5 districts within state. Further, each ECZ comprise local hierarchical ethnolinguistic-clusters (ELCs). Tribes occupy lowest ELC substratum followed by lower, middle and
higher castes. Sickle cell is confined to tribal ELCs of Dravidian GL. Within the geographical areas of these tribal ELCs, HBS gene flow to other caste GLCs is evidenced, inferring historical and socio-cultural processes underlying the highly stratified HBS population frequencies. We attempt to evaluate these processes, based on anthropological literature, to interpolate published HBS population frequencies. THREE high risk tribal ELC foci corresponding to sickle cell spread in 31 districts as core ECZs are identified. Further, 98 districts are considered as extensions of core ECZs providing a contour of sickle cell spread in India. Disease burden for total HBS spread,129 districts estimated population in 2020, stands at around 3 lakh sickle cell anemia (SCA) homozygote sufferers with an increment of around 4-5000 births per annum. We map the HBS spread to the district level with estimates of disease burden to aid prioritization of public health efforts in these areas.