By Treezer Michelle Atieno
World Health Organization (WHO) statistics show that in every 200 live births in Kenya, 1 child is born with Sickle Cell Anaemia.
Sickle Cell Anaemia cases in Kenya are most prevalent in Nyanza and Western regions- places that also record the highest malaria cases in the country. In Western Kenya, every year, 4.5 % of the births are of children born with Sickle Cell Anaemia. In Nyanza, 0.6% of the children born have this disease.
Data retrieved from Bungoma County Referral Hospital show that 3,989 cases of sickle cell anaemia were reported between 2018 to 2020 in Bungoma County. 1,420 in 2018, 1,530 in 2019 and 1,044 in 2020. 19 deaths were reported in 2018, 34 in 2019 and 12 in 2020. This totalled Sickle Cell Anaemia death-related cases to 65 in three years.
“Sickle Cell Anaemia is an inherited condition from parents who are both carriers of the genotype “S”. A normal hemoglobin is constituted by alleles “AA” while a sickle cell trait is constituted by “AS”,” explains Dr. Dickens Lubanga, a pediatrician at Bungoma County Referral Hospital.
A child infected by Sickle Cell Anaemia inherits the abnormal alleles from both parents to end up with hemoglobin “SS”. The sickle shaped Red Blood Cells die early, leaving a shortage of healthy Red Blood Cells. This condition is known as Sickle Cell Anaemia.
“Crisis is a major symptom of Sickle Cell Anaemia. It is caused when sickle shaped cells block the blood flow in the body, causing severe pain,” explains Dr. Lubanga.
Other symptoms are swelling of hands and feet, frequent infections- since Sickle Cell Anaemia damages the spleen- delayed growth or puberty, and vision problems.
SICKLE CELL ANAEMIA AND MALARIA
“While carriers of Sickle Cell Aneamia (AS) are not affected by severe Malaria or do not experience malaria attacks, Sickle Cell Anaemia patients are at high risk of getting malaria because of their already weak immune systems. Malaria and Sickle Cell Aneamia both travel through the blood and reduce the amount of blood in the body. When Malaria attacks a Sickle Cell Aneamia patient, a blood transfusion is always required,” explains Dr. Lubanga.
Sickle Cell Anaemia patients are also at a high risk of getting severe Malaria or Cerebral Malaria. Cerebral malaria affects the brain by causing it to swell and sometimes causing permanent brain damage. Chances of death are high for a Sickle Cell Anaemia patient with Cerebral Malaria.
In the treatment of sickle cell anaemia, malaria prophylaxis is mandatory. This prevents severe Malaria attacks on the patients.
Folic acid is another drug used for the treatment. This drug helps to boost the amount of blood in the body.
RECOMMENDED SOLUTIONS FOR THE FIGHT AGAINST SICKLE CELL ANAEMIA
“There is a need to educate society about Sickle Cell Anaemia. This is because even in this era, with the health advancements made in Kenya, some parents still hide their children suffering from sickle cell anaemia from the public eye,” says Dr. Lubanga, adding that other parents believe the disease is a curse and opt to visit native doctors for solutions instead of seeking medical attention.
Other recommendations are that blood banks should be made available in most hospitals in the country because of the frequent blood transfusions that these children need- like in the case of Bungoma, the closest blood bank is in Eldoret, 102.6 kilometres away.
Dr. Lubanga also recommends that couples undergo blood screening before marriage to ascertain if they have sickle cell traits.