Dahod health dept initiative: High-performance machine to fight sickle cell disease

However, with a more receptive tribal population, programme officer for SCD and Epidemic Medical Officer, Dahod, Dr Nayan Joshi, says the district is now preparing to gather definite data on the disease and test those who have Dithionite Tube Turbidity (DTT).

Dr Joshi said, “So far, we do not have definite comparative data in the district because there was no HPLC machine that could help ascertain the exact number of persons with sickle cell and those who are carriers of the trait…
Individuals, who test positive for DTT — the primary screening method in mass testing — can also just be carriers of
the trait. The district health department has issued a tender for the procurement of the HPLC machine.”

As part of the mass testing of 4,800 students in 15 tribal schools for the Azadi ka Amrut Mahotsav event, 546 students turned out to be DTT positive. In another general camp with an 18,000 testing, 1,190 persons tested positive for DTT and when some of the samples were sent for HPLC testing, 41 turned out to be diseased.

On World Sickle Cell Day on June 19, the department conducted a camp for 360 pregnant women and 145 close family members, where 193 persons tested positive for DTT.

“We send some of the samples of those who test positive for DTT for HPLC test to Gandhinagar or Godhra in Panchmahal. We focus on counselling of families to ensure primary testing for all and also prenatal diagnosis for young couples who are trait carriers,” said Joshi.

The health department has begun consistent counselling of tribal families to discourage marriages of persons with sickle cell or traits, given that a majority of the younger generation of tribals from the district migrate to other parts for work.

Joshi said, “This week, we held a camp for health workers, making them aware of the factors involved in the inheritance of the disorder from parents… We have been conducting this counselling for tribal couples and families on a routine basis, encouraging soon-to-be-married couples to come and test for sickle cell.”

Joshi explains that like any genetic disorder, if both parents are carriers of the sickle cell trait, then the child has a 25% chance of inheriting it. He said, “For many years, tribals lived unaware that there is a 25 per cent chance of the offspring being diseased, 50% chance of the offspring being a carrier of the trait, and only 25% chance of the child being normal. Now, as awareness has increased, they understand the importance of testing.”

The work on sickle cell awareness took a hit during the Covid-19 pandemic but the department, which has 33 sickle cell counsellors now, is back focusing on ante-natal care and encouraging those children born after 2012 to be screened.

“We have successfully counselled 12 couples during the drive. Some of them who are carriers of the trait and expecting, are coming in for the pre-natal diagnostic test for sickle cell… In case the foetus is a carrier, it is fine but if the foetus is diseased, then we recommend a Medical Termination of Pregnancy (MTP),” Joshi said.