Rochester, MN, November 26, 2014 (GMN) - Most African descendants and other nations are wondering what blood disorder is so-called “sickle cell anemia”.

According to Grosse, et al., 2011, sickle cell anemia appeared to be an inherited form of anemia condition in which has not enough normal red blood cells that carry adequate oxygen throughout the body. Normally, red blood cells are flexible and round and move easily through the blood vessels. In sickle cell anemia, the red blood cells become rigid, sticky, and are crescent shape. These irregular-shaped cells can get stuck in small blood vessels which can slow or block blood flow and oxygen to parts of the body as the results cause lots of pain. This blood disorder disease is usually present in childhood and commonly passed on through parents with red blood cells forming an abnormal.

The risk of inheriting sickle cell anemia comes down to genetics and baby to be born with sickle cell anemia, both parents must carry a sickle cell gene. The gene is more common in families that come from Africa, India, Mediterranean countries, Saudi Arabia, the Caribbean islands, and South and Central America. In the United States, it most commonly affects black communities (Yusuf, H., et al, 2011).

Most concern striking healthcare industries, it believes to be one of the most commonly affecting people individually but not as a public health concern due to genetic disease in certain places in the world. Grosse, et al, 2011, indicated that sickle cell disease (SCD) is common throughout much of sub-Saharan Africa and affected up to 3% of births in some parts of the continent. The disease is still prevalent; especially among people with recent ancestry who live in malaria-stricken areas as it mention above. Malaria was historically endemic to North America and Southern Europe but it was declared eradicated in the mid-20th century with the exception of rare sporadic cases. Statistically, in Africa SCD is reported to be associated with a very high rate of childhood mortality, 50%–90%, yet there is a lack of reliable up-to-date information (Grosse, et al, 2011). In the USA, where there is no endemic malaria, the prevalence of sickle-cell anemia among blacks is lower about 0.25% than in West Africa about 4.0%, and is falling. Without endemic malaria, the sickle cell mutation is purely disadvantageous and will tend to be selected out of the affected population through natural selection; However, the African American community of the USA is known to be the result of significant admixture between several African and non-African ethnic groups, and also represents the descendants of survivors of the slavery and the slave trade.

The impact of sickle cell Anemia on individual cognitions and behavior has affected many African communities mainly in some particular states such as Minnesota where more than 70,000 to 80,000 immigrants settled from 1990 to the present.  Few theories were used in health behavior and health education to offer explanations of how the disease affects children geographically.  I personally have seen this problem in African communities; particularly in my community, children are brought to hospital every often with pain and terrified parents.

In fact, the essence of SCD’s behavior toward individuals has been noted a very little concerned in public health practices and increased more attention which brought critics for limited treatment and prevention  The treatment and prevention are only effective in developed countries but not in Africa, especially in the rural area where people have limited access to hospital or clinic.  According to, the Multicenter Study of Hydroxyurea (MSH) in Sickle Cell Anemia; stated that Hydroxyurea is a chemotherapy agent with potent effects on the bone marrow. The agent was used for many years to treat people with certain malignancies before being used for sickle cell disease. The primary side-effect of hydroxyurea is the suppression of blood counts, particularly the white blood cells (neutropenia) and platelets (thrombocytopenia). Patients with sickle cell disease who require hydroxyurea therapy are best served by having their treatment coordinated by specialists familiar with the use of this drug (Charache, et al., 1995). Another theory for the low prevalence of sickle cell anemia belief to be effective in the African-American community due to the eradication of Malaria in North America compared to Sub-Saharan Africa. Yusuf, H., et al, 2010, concluded that causes of death among patients with SCD include cardiopulmonary which can be cardiac arrest, heart failure, pulmonary embolism, infections, stroke, and multiorgan failure. Among children hospitalized with SCD, frequent complications include infections and pulmonary conditions.

Tip: new technology

Sickle cell disease can be diagnosed in an unborn baby by sampling some of the fluid surrounding the baby in the mother's womb (amniotic fluid) to look for the sickle cell gene. If a person or partner has been diagnosed with sickle cell anemia or sickle cell trait, ask the doctor about whether one should consider the screening. Ask for a referral to a genetic counselor that can help understand the risk to the baby. If a person carries the sickle cell trait, he/she might wish to see a genetic counselor before trying to conceive a child. A genetic counselor can help a person understand the risk of having a child with sickle cell anemia. He or she can also explain possible treatments, preventive measures, and reproductive options.

Lifestyle and home remedies

Taking steps to stay healthy may help to avoid complications of sickle cell anemia. If the child has sickle cell anemia, one must follow these suggestions to help a child stay healthy:

·        Since bone marrow produces red blood cells, patients may need to folic acid supplements daily and other vitamins to make new red blood cells.

·        Avoid exposure to extreme heat or cold can increase the risk of a sickle cell crisis.

·        Using over-the-counter medications can be fatal because some medications, such as the decongestant pseudoephedrine, can constrict the blood vessels and make it harder for the sickle cells to move through freely.

·        Plan ahead when traveling to high-altitude areas. There is less oxygen at higher altitudes, so people with SCD may require supplemental oxygen to avoid triggering a sickle cell crisis. Meet with the doctor to discuss the risks of traveling to a high-altitude area. High altitude seems to be one of the factors which children with sickle cell anemia cannot tolerate high altitude atmosphere.  As altitude increases, atmospheric pressure will decrease and would affect children by decreasing the partial pressure of oxygen.

·        Finally, Public health needs to develop a system that will benefit and build a database for people with SCD. This will be helpful in addressing issues related to the health, educational, and psycho-social needs of all affected persons and families. Public health professionals and other health practitioners need to collaborate in educational efforts to make sure people are aware of this important public health concern. People with sickle cell disease or those with sickle cell trait, their families, and friends deserve an effective support system. There is no Medicine in the movement to cure sickle cell disease but the world learned that simple intervention significantly improves morbidity and mortality.  Public health needs to extend these benefits to African patients urgently (Serjeant, G. R, 2005). Addressing the public health needs related to SCD is an important step toward improving outcomes and maintaining health for those affected by the disorder.

 

·        References

·        Charache, S,. et al. (1995).  Effect of Hydroxyurea on the frequency of painful crises in sickle cell anemia. Investigators of the Multicenter Study of Hyroxyurea in sickle cell anemia. N. Engl. J. Med. 322:1317

·        Grosse, D. et al. (2011).  Sickle cell disease in Africa: A neglected cause of early childhood mortality.  doi: 10.1016/j.amepre.2011.09.013.

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·        Serjeant, G. R. (2005). Mortality from sickle cell disease in Africa. BMJ ;330:432–3. doi:10.1136/bmj.330.7489.432,  

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·        Yusuf, H., et al. (2011). Sickle cell disease, the need for a public health agenda: Am J Prev Med; 41(6S4):S376 –S383.

·        doi: 10.1016/j.amepre.2011.09.007.       

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·        This is an ambitious program and the participation of dedicated partners is appreciated. If anyone wishes to take part in this project by volunteering time or other resources he/she is most welcome. For further information, contact the following individuals: Omot Olok Dang at 507-322-8034 or This email address is being protected from spambots. You need JavaScript enabled to view it.. www.gambellamedical.org

 

 

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