If recent national statistics on children born with Sickle Cell Disorder (SCD) are anything to go by, then the quest to reduce under-five mortality by two-thirds, which is in line with the Millennium Development Goals (MDG), may remain a Herculean task.
This is because recent data released by the World Health Organisation (WHO) reveal that an average of 150,000 infants are born with SCD in Nigeria, which has an annual infant death figure of 100,000. Hence, the high incidence of sickle cell cases, experts insist, calls for a holistic approach targeted at evolving strategies that will keep the disorder in check.
Torinola Femi-Adebayo, senior medical officer, National Sickle Cell Centre, Idi-araba, Lagos, while speaking with BusinessDay, explained that sickle-cell anaemia (also known as sickle-cell disorder or sickle-cell disease), a genetic condition, stems from inheritance of mutant haemoglobin genes from both parents.
Femi-Adebayo hinted that though a single abnormal gene may protect against malaria, inheritance of two abnormal genes results in sickle-cell anaemia, and is a major cause of ill-health and death among children. According to the medical expert, the public health implications of sickle-cell anaemia are significant, since not all deaths occur in the first year of life. “The management of sickle cell in Nigeria remains inadequate, as no coordinated policy and national control programmes on the… disorder exist. Systematic screening is not a common practice, and more often than not, diagnosis is usually made when a patient presents a severe complication,” she observed.
The medical expert however noted that the National Sickle Cell Centre had established sickle cell clinics in Kano, Delta, Edo and Lagos States, which have so far recorded tremendous success: “People with sickle cell disorder go there to receive treatment free of charge. There is a coordinated plan in place whereby such individuals are made to go for medical checks every three months.”
Minister of Health Onyebuchi Chukwu, while speaking at the recent World Sickle Cell Day campaign with the theme ‘Sickle Cell Disease, 1910 - 2010: 100 Years of Science, Still Seeking Global Solutions”, disclosed that the high incidence of the condition calls for far-reaching control measures. This, she explained, is why the ministry has collaborated with many organisations to scale up SCD management in the country. “Our collaboration with the London Focus Sickle Cell Africa (based in Zankli Clinic, Abuja) has brought about accurate screening and diagnosis of sickle cell disease variants and other forms of haemoglobin abnormalities, both in adults and newborns. The Sickle Cell Foundation of Nigeria has also helped in managing Sickle Cell Centres in communities, mobilising resources and providing telemedicine facilities, including a well-equipped library in Lagos,” the health minister stated.
In view of the public health implications of sickle cell, a coordinated policy on its management in Nigeria should be put in place. The management of the disorder should cover prevention and counselling, early detection and treatment, surveillance and research, including community education and partnership.
Likewise, dedicated centres should be established to guarantee adequate services for prevention and treatment. Ideally, the disease should be identified at birth as part of a screening programme or neonatal diagnosis, and affected individuals urged to visit a centre periodically for evaluation. Besides, management of patients with sickle-cell anaemia should be at the primary health-care level, with emphasis on programmes that use simple, affordable technology and reach a large section of the community. Examples of such programmes include: public education, detection of genetic risks in the community, health and genetic counselling, as well as immunisation against infections.
Finally, a stepwise approach to monitoring of sickle-cell anaemia and its risk factors is required to collect data for better decision-making and technical collaboration, as are partnerships at local, state and national levels which will ensure every stakeholder in the health sector is fully aware of the extent of the problem.
By Alexander Chiejina
No comments:
Post a Comment