Sickle cell disease (SCD) is a genetic disorder that affects the shape and function of red blood cells, which carry oxygen throughout the body. People with SCD have abnormal hemoglobin, a protein in red blood cells, that causes them to become sickle-shaped or crescent-like. These deformed cells can block blood vessels, causing severe pain, infections, anemia, and organ damage. SCD can also lead to complications such as stroke, vision loss, leg ulcers, and pulmonary hypertension.
SCD is inherited from both parents, who may carry the sickle cell gene without having any symptoms. The only way to know if one has the gene is through a blood test. If both parents have the gene, there is a 25% chance that their child will have SCD and a 50% chance that their child will be a carrier of the gene.
Nigeria has the highest burden of SCD in the world, with about 150,000 babies born with the condition every year. According to the World Health Organization (WHO), SCD is responsible for up to 16% of under-five deaths in Nigeria. Many children with SCD die before reaching adulthood due to lack of access to diagnosis, treatment, and prevention services.
However, there have been some efforts to improve the situation of people living with SCD in Nigeria. For example, the Sickle Cell Foundation Nigeria (SCFN) was established in 1994 to provide comprehensive care and support for people with SCD and their families. The SCFN runs a national sickle cell center in Lagos, which offers services such as screening, counseling, education, research, and advocacy. The SCFN also collaborates with other organizations and stakeholders to raise awareness and promote policies that address the needs of people with SCD.
Another initiative that aims to reduce the impact of SCD in Nigeria is the newborn screening program, which was launched in 2006 by the Federal Ministry of Health in partnership with other agencies. The program involves testing babies for SCD within 72 hours of birth using a heel prick test. Babies who test positive are referred to specialized centers for further confirmation and management. The program also provides counseling and education for parents and caregivers on how to care for their children with SCD.
The newborn screening program has been implemented in several states across Nigeria, such as Kano, Kaduna, Anambra, Lagos, Oyo, and Rivers. According to a study published in 2020, the program has been feasible and acceptable in Kano state, where about 23.7% of the population have the sickle cell trait and about 2% have SCD. The study found that most parents were willing to participate in the program and appreciated the benefits of early diagnosis and treatment for their children.
However, the program also faced some challenges, such as inadequate funding, equipment, personnel, and infrastructuren. The study recommended that more resources and support should be allocated to sustain and expand the program to reach more babies and families.
The newborn screening program is one of the ways to prevent some of the complications and deaths associated with SCD. Other preventive measures include taking daily antibiotics and vaccinations to prevent infections, taking medications such as hydroxyurea or voxelotor to reduce sickling of red blood cells, drinking plenty of water and avoiding triggers such as cold or stress that can cause pain crises, eating foods rich in folic acid and calcium to support blood production and bone health, and getting regular check-ups and tests to monitor organ function and blood count.
Additionally, people who have the sickle cell trait or SCD can seek genetic counseling before having children to understand their risks and options. Some couples may opt for assisted reproductive technologies such as preimplantation genetic diagnosis (PGD), which involves screening embryos for SCD before implanting them into the uterus. However, this option may not be affordable or accessible for many people in Nigeria.
Therefore, more efforts are needed to improve the quality of life and survival of people with SCD in Nigeria. This requires a multisectoral approach that involves government, health care providers, civil society organizations, communities, families, and individuals. Together, they can work towards increasing awareness, improving access to care, reducing stigma and discrimination, promoting research and innovation, and advocating for policies and programs that address the challenges of SCD.
SCD is a serious health problem that affects millions of Nigerians. It is not yet defeated, but it can be managed and prevented with proper interventions. By working together, we can make a difference in the lives of people living with SCD and their families.
– Jemirin Precious Oluwakemi
Mass Communication Department,
Prince Abubakar Audu University
