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Sunday, March 1, 2015

Sickle Cell Anemia In Africa

Sickle Cell Anemia In Africa

Nigeria accounts for more than 100,000 new sickle-cell anemia cases each year.

Nigeria accounts for more than 100,000 new sickle-cell anemia cases each year.

Sickle-cell disease (SCD) or sickle cell anemia is described as a change in the shape of the red blood cell from a smooth, donut shape into a crescent or half-moon shape. 

The misshapen cells lack flexibility and can block small blood vessels, blocking blood flow. This condition leads to shortened red blood cell survival, and sickle-cell anemia. Poor blood oxygen levels and blood vessel blockages in people with sickle-cell disease can lead to chronic acute pain disorders, severe bacterial infections, and tissue death. SCD dominates non-communicable disease issues in sub-Saharan Africa. SCD can occur only when both parents are carriers of trait genes for the condition. 

In countries such as Cameroon, Republic of Congo, Gabon, Ghana and Nigeria, the prevalence of SCD is between 20 percent and 30 percent while in some parts of Uganda it is as high as 45 percent. According to the Center for Disease Control and Prevention (CDC) 75 percent of all patients with SCD live in Sub-Saharan Africa, Nigeria alone accounts for more than 100,000 new births every year.

The majority of children with the most severe form of the disease die before the age of five, usually from an infection or severe anemia. Regular screening for SCD using a simple blood test is not a common practice, and diagnosis is usually made when a severe complication occurs. Presently, there is no cure for SCD. Environmental factors often play a role in the occurrence of painful attacks. Common triggers include cold temperatures, dehydration, excessive amounts of exercise and tobacco smoke. Other triggers such as plane flights and high altitudes can also trigger an attack.

However, cost-effective treatment exists for the pain and other aspects of the disease. The most important components of this treatment are early intervention. Creation or strengthening of Africa’s sickle-cell disease programs is essential. WHO states essential areas of work should cover advocacy; prevention and counseling; early detection and treatment; data collection, surveillance and research; and community education and partnerships. 

Sickle cell anemia can be managed by simple procedures including high fluid intake, healthy diet, folic acid supplementation, pain medication, vaccination and antibiotics for the prevention and treatment of infections and a number of other medicinal procedures. Management of sickle-cell disease at different levels of the health-care system should emphasize programs that use simple, affordable technology and are accessible to a large proportion of the community. 

Family and community-based care should be an integral part of the national program. The WHO Regional Director for Africa Dr Matshidiso Moeti has called for more investment, stronger collaboration and partnerships to stem the tide of the rising cases of sickle cell disease in Africa.

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