Union Budget 2023: What is sickle cell anaemia; can it be eliminated?

However, it is possible to eliminate sickle cell anaemia?

Terming it as a herculean task, Dr Sachin Shah, director – neonatology and pediatrics Intensive Care Unit, Surya Hospitals, Pune, listed some of the challenges. “It is possible but a herculean task. We need to screen all population for sickle cell trait especially high risk communities. Individuals will sickle cell trait should not marry each other since there is a 25 per cent chance of having a baby with sickle cell disease. If they get pregnant, then we need to screen foetus for sickle cell disease and terminate the pregnancy if parents wish,” said Dr Shah.

Dr Sandeep Singh, a haematologist too agreed and said that it is only “partially possible” to eliminate the disease by public awareness because it is caused by a “consanguineous marriage which can be avoided.”

For the unversed, Sickle cell disease (SCD) is an inherited group of blood disorders that is genetic in nature. It is usually transferred from the parents to the child during birth i.e. both parents can be carriers of SCDs. “The sickle cells die prematurely, resulting in a chronic lack of red blood cells. Furthermore, as they pass through small blood arteries, they become caught and obstruct the blood flow. This can result in discomfort as well as other dangerous consequences (health issues) such as infection, acute chest syndrome, and stroke,” said Dr Aniket Mule, consultant internal medicine, Wockhardt Hospitals, Mira Road.

While healthy RBCs are round in shape, move through small blood vessels, and carry oxygen to all parts of the body, in someone who has SCD, the RBC becomes sticky and hard and assumes a C-shape, similar to that of a farm tool ‘sickle’, explained Dr Rahul Bhargava, director and head, haematology and bone marrow transplant, Fortis Memorial Research Institute, Gurugram.

Sickle cell trait need to be screened (Source: Getty Images/Thinkstock)

What are the symptoms of sickle cell anaemia?

Babies with sickle cell anaemia may not exhibit symptoms for several months after birth. The symptoms of anaemia, however, include excessive weariness or fussiness, excruciatingly swollen hands and feet, and jaundice. “Babies may also suffer spleen damage, which weakens their immune system and increases their susceptibility to bacterial infections. People with sickle cell anaemia may have various and increasingly significant medical problems as they age, which occur when organ tissues do not receive enough oxygen,” Dr Mule said.

What is the procedure for diagnosing sickle cell disease (SCD)?

A blood test can determine whether you have SCD or sickle cell trait. All states now check babies as part of their screening programmes, allowing treatment to begin as soon as possible.

*People who are considering having children can get the test to determine the likelihood of their offspring having SCD.

*SCD can also be diagnosed before a baby is born. A sample of amniotic fluid (the fluids in the sac around the foetus) or placental tissue is used in this test (the organ that brings oxygen and nutrients to the baby).

Dr Gutha added that extended family screening is recommended for people who are carriers, who have a family history of sickle cell diseases.

What treatment therapies are available for sickle cell disease (SCD)?

SCD can only be cured by bone marrow or stem cell transplantation, Dr Mule noted. “These transplants are normally reserved for children with severe SCD since they are hazardous and can have substantial adverse effects. The bone marrow must be a close match for the transplant to succeed. A brother or sister is usually the ideal donor,” said Dr Mule.

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