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Despite claiming medical breakthrough, Nigeria remains world’s most endemic nation with sickle cell disease

WORLD Sickle Cell Day is observed globally on June 19 to raise public awareness of sickle cell disease (SCD), a significant yet often overlooked global health concern affecting millions worldwide.

With this year’s theme, “Hope through Progress: Advancing Care Globally,” the purpose is to raise awareness about the condition and the challenges faced by patients, their families, and caregivers.

The US Centre for Disease Control (CDC) defined sickle cell as a group of inherited red blood cell disorders. Red blood cells contain haemoglobin, a protein that carries oxygen. Healthy red blood cells are round and move through small blood vessels to carry oxygen to all parts of the body.

“In someone who has SCD, the haemoglobin is abnormal, which causes the red blood cells to become hard and sticky and look like a C-shaped farm tool called a sickle. The sickle cells die early, which causes a constant shortage of red blood cells. Also, when they travel through small blood vessels, sickle cells get stuck and clog the blood flow. This can cause pain and other serious complications (health problems) such as infection, acute chest syndrome, and stroke,” the CDC said.

The SCD symptoms include severe pain episodes also known as sickle cell crises, anaemia, fatigue, swelling in hands and feet, frequent infections, and delayed growth in children.

Treatment focuses on managing symptoms and preventing complications, including pain relief medications, blood transfusions, and hydroxyurea to reduce crises.

Sickle-cell anaemia is particularly common among people whose ancestors come from
sub-Saharan Africa, India, Saudi Arabia and Mediterranean countries, the World Health Organisation said.

The WHO added that migration raised the frequency of the gene in the American continent, stressing that in some areas of sub-Saharan Africa, up to two per cent of all children are born with the condition.

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Nigeria has been identified as the global epicentre for people living with SCD, according to the Pan African Medical Journal.

“About 50 million people are living with SCD globally and Nigeria is the epicentre zone with about four to six million people living with the disease (one in every four Nigerians has a sickle cell trait).

The Nigerian government acknowledged this fact while briefing journalists at an event commemorating World Sickle Cell Day in Abuja on Wednesday, June 19.

“Nigeria stands out as the most Sickle Cell Disease endemic country in Africa and globally, ahead of India and Democratic Republic of Congo, with an annual infant death of 100,000 representing eight per cent of infant mortality and those that manage to survive suffer end-organs damage which not only shortens their lifespans but also affects their quality of life across the life course.

“The 2018 NDHS report put the prevalence of the disease in the country at one per cent while 25 per cent of Nigerians are healthy carriers of the disease, said the Minister of Health and Social Welfare, Muhammad Ali Pate.

Pate, who was represented by the Director of Public Health, Chukwuma Anyaike at the event, however, said the government had instituted policies and several strategic interventions to address the challenges posed by the disease and that the government recognised the “huge burden of socio-economic and psychological effects” of SCD.

The government admitted its failure in managing the crisis, citing several hurdles.

“The situation in the (African) region also indicates that national policies and strategic action plans are inadequate; appropriate facilities and trained personnel are scarce; adequate diagnostic tools and treatments are insufficient, as well as synergy amongst various stakeholders and NGOs in the prevention and control of the disease.”

It further explained that the policies and interventions it had in place included the development of the first national guidelines for the prevention and control of the disease, and the Universal Newborn Screening policy adopted to ensure that all children born in Nigeria are screened for SCD, among others.

Nigeria failed to stop SCD despite its claims that it had produced drugs to manage the condition.

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In May 2023, the Minister of Science and Technology, Olorunnimbe Mamora, said the ministry had developed diagnostic processes, treatment and drugs for sickle cell, hypertension and others through its agencies.

“Nigeria has a very large population of sickle cell disease patients and carriers. To that effect, I can tell that we have developed products from plants that combat or are anti-sickening in nature and therefore reduce the number of attacks that usually result from sickle cell anaemia.”




     

     

    The ICIR reports that it remains unclear what has become of the acclaimed breakthroughs.

    Speaking with The ICIR on SCD, a consultant haematologist at Maitaima Hospital, Abuja, Stella Madueke, noted that preventing SCD starts with giving pre-marital counselling to intending couples.

    Besides, children born to both AS parents are to go through neonatal screening.

    She added that people who undergo early screening, diagnosis, and management have better chances to survive.

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