SPECIAL REPORT: Sickle Cell Consciousness- A Public Well being Crucial for Nigeria
By Hadiza Yusuf Ahmad
Sickle Cell Illness (SCD) is a genetic situation that impacts the blood. In folks with SCD, the crimson blood cells, which usually appear to be spherical disks, turn into formed like a crescent or a sickle.
This variation in form makes it tough for the cells to maneuver by blood vessels and carry oxygen to the physique’s organs. SCD is generally inherited from dad and mom who carry the sickle cell gene.
Based on the 2022 analysis by PubMed Central, Nigeria has the best international burden of sickle cell illness, with an estimated 2-3% of the inhabitants affected which interprets to roughly 150,000 newborns recognized yearly.
These statistics had been additional consolidated in 2024 by the Nigeria Coverage Influence which states that Nigeria is the epicenter of sickle cell, accounting for 4-6 million of the estimated 50 million international instances.
These figures, sourced from respected organizations, Spotlight the important want to deal with the challenges confronted by people dwelling with sickle cell in Nigeria, significantly in the course of the harmattan season.
Usually, the harmattan season brings a chill to the air for a lot of, however for Aisha, who’s affected by Sickle Cell Illness (SCD), it brings a life-threatening battle with agonizing ache. Because the onset of the dry season, she has endured a number of hospital visits, every a distressing reminder of the fixed battle towards sickle cell anemia.
For her, relapses are frequent, usually occurring instantly after remedy. To handle the Insufferable ache, Aisha undergoes common blood transfusions, a process she faces each two months. But, even these transfusions supply solely non permanent aid, with Aisha typically experiencing a relapse earlier than even leaving the hospital.
Additionally, Ayuba Ibrahim (not his actual identify), a sickle cell affected person who was groaning in ache within the hospital however at any time when his dad and mom tried to consolation him, he turned livid and advised them to depart him alone. He blamed their determination to marry regardless of warnings about genetic incompatibility for his present situation, battling life-threatening crises nearly each day.
Maryam, one other affected person, shared her despair, stating, “I’ve given up on life as a result of this sickness feels limitless. Daily brings a brand new problem. I can get up feeling robust, however inside hours, I’m struck by a disaster that leaves me hospitalized for days. I urge {couples} to take genotype testing severely. Ignoring genetic compatibility can have devastating penalties for future generations.” She remarked sadly.
Maryam’s mom recounted her expertise saying “I acquired married in a time with little consciousness about genotypes. I didn’t even know what genotype was, and as a baby, Maryam hardly ever confirmed indicators of sickness. She used to fall sick yearly, recuperate absolutely, and proceed along with her actions. However in recent times, she has suffered extreme and frequent crises. Typically, we doubt if she’ll make it by.
“If I had identified about genotype testing and the affect of genetic incompatibility, I might by no means have gone by with the wedding. Now, I encourage youthful generations to make knowledgeable selections and keep away from the ache we’re experiencing,” she stated.
The pitiful mom recounts how monetary constraints compelled them to combine conventional drugs into the remedy of Maryam’s illness.
“Monetary challenges have been overwhelming. We barely handle to get by. At one level, we turned to conventional natural drugs, believing it might remedy her. Sadly, it solely made issues worse. Dehydration, which triggers crises, was exacerbated when the natural practitioner prohibited her from consuming water, insisting she solely take water infused with herbs. It turned out he was a quack. Now I do know higher and warning others towards such practices.” She added.
A medical well being knowledgeable, Dr. Aliyu Shehu, who’s a senior registrar within the Hematology Division at Aminu Kano Educating Hospital (AKTH), has shed extra mild on the complexities of sickle cell illness (SCD), emphasizing its genetic origins, related problems, and methods for prevention and administration.
Dr. Shehu defined that sickle cell illness is a hereditary blood dysfunction brought on by irregular hemoglobin manufacturing. This situation, he famous, results in the manufacturing of faulty crimson blood cells susceptible to “sickling” when uncovered to stressors reminiscent of low oxygen ranges, excessive climate circumstances, infections, or different sicknesses.
“When sickling happens, it could possibly block blood vessels and result in varied crises, together with vaso-occlusive, hemolytic, and aplastic crises,” Dr. Shehu stated. He harassed that SCD can have an effect on each a part of the physique, from the mind and liver to the kidneys and even the pores and skin, usually leading to problems reminiscent of leg ulcers which are immune to remedy.
Learn Additionally:
Moreover, Dr. Shehu categorized the illness into three most important sorts: sickle cell anemia, sickle cell illness, and sickle cell trait. He defined that sickle cell anemia additionally known as hemoglobin SS, is essentially the most extreme kind, as each inherited hemoglobin genes are irregular.
Based on him, prevention begins with genetic screening earlier than marriage. “Mother and father should be screened to establish their service standing as a result of a baby inherits the illness after they obtain the irregular gene (S) from each dad and mom,” he suggested.
In managing crises, Dr. highlighted the function of fetal hemoglobin (hemoglobin F) in mitigating signs. “Fetal hemoglobin, which is current at delivery, prevents sickling. Nevertheless, as kids develop, it’s changed by grownup hemoglobin (hemoglobin A), which contributes to the onset of sickle cell crises. In some instances, people retain greater ranges of hemoglobin F into maturity, resulting in milder signs,” he defined.
He additionally touched on the affect of coexisting genetic issues, reminiscent of thalassemia, in lowering the severity of sickle cell illness. “Whereas thalassemia is mostly dangerous, its coexistence with sickle cell anemia can reduce the frequency of crises by modifying the construction of the hemoglobin chains,” he famous.
He additionally stated typically to handle sickle cell, the affected person has to bear blood transfusion which entails transferring wholesome crimson blood cells from a donor to the affected person. This helps enhance oxygen supply within the physique, scale back the variety of sickled cells, and handle problems like extreme anemia or organ injury. It may well alleviate signs, forestall strokes, and enhance general well being, however it requires cautious matching and monitoring to keep away from dangers like iron overload or reactions. He stated.
He added that one of the best ways to handle a medical disaster is to go to a hospital instantly when it happens to obtain correct remedy and drugs.
Dr. Shehu highlighted a big remark relating to the prevalence of sickle cell crises, emphasizing that the situation is usually aggravated in the course of the heating season. He defined that dehydration is a serious contributing issue, as even wholesome people are susceptible to dehydration throughout this era.
Nevertheless, for people with sickle cell anemia, dehydration exacerbates the chance of crises, opposite to the frequent perception that crises are extra frequent throughout harmattan. He famous that crises are minimal throughout harmattan in comparison with the warmth season.
Based on Dr. Shehu, the best method to combating sickle cell anemia is prevention. He harassed the significance of {couples} realizing their genotypes earlier than marriage. Governments, he steered, ought to implement and implement insurance policies discouraging marriages between people with incompatible genotypes, reminiscent of AS and AS or AS and SS, to cut back the prevalence of the illness in future generations.
Dr. Shehu dismissed claims by conventional drugs practitioners that they’ll remedy sickle cell anemia. “There has by no means been any natural drugs confirmed to remedy sickle cell anemia or change a person’s genotype,” he acknowledged. He shared instances of sufferers who had been misled into counting on natural therapies, solely to undergo extra frequent crises and return to traditional medical care with worsened circumstances.
The medical knowledgeable additionally famous that whereas bone marrow transplants stay the one identified remedy for sickle cell anemia, He cautioned in regards to the dangers concerned. Many sufferers face rejection after a profitable transplant, because the physique perceives the overseas cells as threats and launches an immune response. This rejection can result in problems and, in some instances, dying. Though some sufferers have had profitable transplants, the process stays dangerous and inaccessible to many.
Thus, Dr. Shehu underscored the necessity for government-led consciousness campaigns to teach the general public about sickle cell anemia. Elevated consciousness of the illness’s affect and prevention methods might considerably scale back its prevalence and guarantee a more healthy future era.
He added that the monetary burden of managing sickle cell anemia is overwhelming for a lot of households. Drugs, a few of which should be taken hourly, are sometimes prohibitively costly. Whereas sufferers coated by the Nationwide Well being Insurance coverage Scheme (NHIS) pay much less, many nonetheless battle to afford remedy. Dr. Shehu emphasised that the excessive price of care leaves quite a few sufferers untreated even after enduring extreme crises.
Dr. Shehu referred to as for elevated schooling, and coverage implementation, to alleviate the challenges confronted by people dwelling with sickle cell anemia and their households, by emphasizing the significance of public consciousness, early prognosis, and way of life changes to cut back the frequency and severity of crises. He inspired people and households affected by the situation to hunt medical recommendation and help to handle its impacts successfully. He added that sickle cell illness is price avoiding as it may be preventable
Sickle cell illness stays a big public well being concern, and consultants like Dr. Shehu proceed to advocate for preventive measures and higher take care of these dwelling with the situation.
Hadiza Yusuf Ahmad is a PRNigeria Fellow 2024, she writes from Kano and might be reached through [email protected]
