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FACTS ABOUT SICKLE CELL DISEASE
The destiny of Nigerians having sickle cell disease is left in the hands of God because they seem not to be receiving enough attention from the society and Government. The pains these patients experience and the psychological effects on their parents worth telling the world that these category of people need our care, support and counseling.
If the strategy use by the Government for the control of HIV can be used for the prevention of this disease that equally has no cure then the country will be free of this agonizing disease.
The high incidences of sickle cell disease can be traced to either ignorance or “Blind Love”. Many people want to marry the man or woman of their choice irrespective of the medical history of the parties involved. In many cases patients have refused to be counseled that they were not compatible for marriage. They insisted on going ahead because it was for better for worse but at end they may not be able to cope with the worse part of it. Others fall into the category of those who do not know what sickle cell is all about. They just find themselves in the mess.
It is difficult to say which category the parents of the child that was thrown into the Lagoon, which was widely reported on the dailies of April 12th 1998, fall. No matter what, the parents should seek for forgiveness from God despite the fact that it is hectic to nurse a sickler.
My experience in the Laboratory at University College Hospital (U.C.H.) Ibadan made me to put these pieces down for people to learn and be informed. There was a would-be couple that came to the Laboratory for general screening tests that they said was an advice from a friend. After the tests were performed they were said to be free from AIDS, HEPATITIS and the BLOOD GROUPS were O rheus D positive. The only problem was that they were not compatible to marry because they were having traits of sickle cell disease (AS genes). The lady started crying and made us to believe that nothing would stand on their way to the altar as they have prayed for it. To hit the nail on the head the woman came back after two years to confess that after their first daughter they have been enveloped with fear of having another child. She stated that their first was diagnosed to be sickle cell patient and that huge amount of money has been sunk into the management of the disease.
Another terrible incident was how genotype broke a marriage that has produced three kids. The man accused the wife of infidelity when the last child was diagnosed to have SS genes responsible for the sickle cell disease while the man was having AA genes (a normal). This eluded medical theory as a normal father with AA cannot beget a sickle cell child no matter the genes of the mother. The threatened to throw the woman out of the house unless she could produce the real father of the child or get a professor to prove the scientific theory wrong. It was the knowledge of genotype that helped the husband to detect this foul play.
Sickle Cell is an inherited, chronic blood disease where the red blood cells become crescent shaped and function abnormally. When the blood cells become cresent/sickle shaped, they are unable to deliver adequate amounts of oxygen to other cells. The Sickle Cell Disease results in anemia (low blood counts), episodes of pain and increased susceptibility to infections.
Sickle cell is inherited from your parents. It occurs in people who have inherited the gene hemoglobin S from both parents. In order to inherit the disease from your parents, each parent must be a carrier for the sickle cell trait. You can also inherit sickle cell anemia if one of your parents is a carrier for the trait and the other parent has sickle cell. Carriers of the sickle cell gene are said to have sickle cell trait. Unlike sickle cell disease, sickle cell trait does not cause health problems. In fact, sickle cell trait is protective against malaria a disease caused by blood-borne parasites transmitted through mosquito bites.
Sickle Cell cannot be “caught” by touching someone who has it. It can only be inherited from your parents. If you have Sickle Cell Anemia, you are born with it. It will not go away.
There are many symptoms for sickle cell. Individuals with sickle cell may not experience all of these symptoms. The symptoms include: family history of sickle cell anemia, fatigue, breathlessness, rapid heart rate, delayed growth and puberty, susceptibility to infections ulcers on the lower legs (in adolescents and adults) jaundice, attacks of abdominal pain, weakness, joint pain, fever, vomiting, bloody (hematuria) urination, excessive thirst, excessive penis pain, priapism, chest pain and decreased fertility.
Symptoms may not appear until four months after birth and are most severe during an acute episode.
The management of sickle –cell disease falls naturally into the question of maintenance and the treatment of the crises. The establishment of a pattern of regular clinic visit by the patient is the most important step.
The government should take it upon her to establish a place of genetic counseling where young adults seeking advice before marriage will be educated. Our hospitals should be equipped with heamoglobin electrophoretic machines to provide easy detection.
School should make the teaching of sickle cell disease part of their curriculum and mandate the students to know their genotype.
Churches should continue in their campaign in making genotype-screening pre requite for joining couple together.
Parents should encourage their children to lead normal lives, but in order to decrease the occurrence of sickle cell crises, the following precautions should be considered:
Avoid strenuous physical activity especially if the spleen is enlarged and emotional stress. Avoid environments of low oxygen content (high-altitudes, non-pressurized airplane flights) and known sources of infection.
To promote hydration, recognize signs of dehydration and avoid excess exposure to the sun. Provide access to fluids at home and when away from home
Keep child properly immunized as recommended by the health care provider.
Share above information with teachers and other caretakers as appropriate.
The government of Obasanjo should try to make the treatment of the disease free at all level. Federal Ministry of Health should start Television, Radio and Newspapers enlightenment programs to educate the citizens on sickle cell disease just like that of AIDS and Tobacco control.
The effort of sickle cell club of Nigeria should be intensified to make sure that every household is informed about the causes, effects and management of sickle cell disease. Also men should note that this disease is not sexually transmitted disease and the best way to eradicate the disease in the millennium is for people with normal genes AA to marry people with sickle cell genes SS or AS instead of isolating them. They need our care.
B.sc (Hons) Ife, AIMLS, MBA, M.sc (Lagos)
BIMADE DIAGNOSTIC SERVICES
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