Context: The Tribal Minister of India launched a training session for an awareness campaign that’s part of the government’s mission to make India free of Sickle-cell disease (SCD) by 2047.
- It is a group of inherited red blood cell disorders that are caused by a mutation in the hemoglobin gene. This mutation leads to the production of abnormal hemoglobin, known as hemoglobin S (HbS), which causes red blood cells to take on a sickle-like (C-shaped) shape instead of their normal round shape.
- It is caused by a change in hemoglobin, the protein in red blood cells that carries oxygen to all parts of the body. This type of hemoglobin is called hemoglobin S.
- When red blood cells with hemoglobin S go through the smallest blood vessels, called capillaries, some of the cells form into rigid strands and become sticky. These rigid, sticky strands often get stuck, clogging the capillaries. As a result, different parts of the body do not get the oxygen they need.
Types of SCD
- There are several types of SCD. The specific type of SCD a person has depends on the genes they inherited from their parents. People with SCD inherit genes that contain instructions, or code, for abnormal hemoglobin.
- If the sickle cell is inherited from one parent, it is called sickle cell trait or sickle cell carrier. If inherited from both parents, it is called sickle cell disease or sickle cell anaemia (homozygous sickle cell).
- Sickle cell disease exists in two forms within the human body.
- One is the Sickle Cell trait, in which the individual does not exhibit any disease or symptoms and lives a normal life.
- The second form is characterized by the presence of symptoms related to sickle cell disease.
- If two individuals with Sickle Cell trait marry each other, there is a high probability that their child will have Sickle Cell disease.
- By screening individuals for Sickle Cell trait before marriage, the spread of the disease can be prevented.
Signs and Symptoms
Early symptoms of SCD may include:
- Yellowing of the skin and whites of the eyes.
- Fatigue or fussiness from anemia.
- Painful swelling of the hands and feet.
- It is a lifelong illness. It is a genetic disorder, making complete elimination a challenge that requires a major scientific breakthrough.The only cure comes in the form of gene therapy and stem cell transplants — both costly and still in developmental stages.
Case fatality rate
- Moreover, sickle cells die early, resulting in a shortage of red blood cells that deprive the body of oxygen. These obstructions and shortages may cause chronic anaemia, pain, fatigue, acute chest syndrome, stroke, and a host of other serious health complications.
SCD in India
- India is the second-worst affected country in terms of predicted births with SCA — i.e., chances of being born with the condition.
- In India, around 18 million people have sickle cell traits and 1.4 million patients have sickle cell disease.
- It is widespread among the tribal population in India where about 1 in 86 births among STs have SCD.
- A few states in India have a significantly higher SCD prevalence. These include Chhattisgarh, West Bengal, Uttar Pradesh, Maharashtra, Madhya Pradesh, Jharkhand, Gujarat, Odisha, Kerala and Rajasthan. Collectively, these states are referred to as the sickle cell belt.
- Ministry of Health under the National Health Mission initiated the work on hemoglobinopathies (Thalassemia & Sickle Cell Disease) in 2016 wherein comprehensive guidelines on prevention and management of heamoglobinopathies were released and provision of funds towards screening and management of Sickle cell disease were made.
- The Ministry of Health, in collaboration with the Ministry of Tribal Affairs and the states, has formulated a plan to screen approximately 70 million individuals aged 0-40 years belonging to tribal and other groups residing in nearly 200 districts of 17 states within the next few years.
- Sickle Cell Anaemia Elimination Mission 2047: To eradicate the challenge of sickle cell. The government has allocated a sufficient budget, utilised advanced technology, provided training to healthcare workers, ensured necessary infrastructure, and made efforts in social awareness and participation to combat this disease.
- Role of Ayushman Bharat in controlling SCDs: Through the Ayushman Bharat scheme, the country has established a network of 1.6 lakh Health and Wellness Centres since 2018 these centres will also play a significant role in eradicating sickle cell disease along with other diseases.