Health
Live A Full Life With Sickle Cell Disease
Kunle Tometi a Pharmacist, Entrepreneur and Public Health Advocate.
The World Sickle Cell Day is a United Nation’s recognized day to raise awareness about sickle cell disease (SCD) at a national and international level. On 22nd December 2008, the UN General Assembly adopted a resolution that recognizes sickle cell disease as a public health issue and “one of the world’s foremost genetic diseases.” The resolution calls for UN member states to raise awareness about sickle cell on June 19th of each year.
In this article, I would be creating awareness on sickle cell disease, the causes, symptoms, treatment and prevention.
What is sickle cell disease (SCD)
Sickle cell anemia (sickle cell disease) is a disorder of the blood caused by inherited abnormal hemoglobin (the oxygen-carrying protein within the red blood cells). The abnormal hemoglobin causes distorted (sickled) red blood cells.
Occurrence
SCD is more common in certain ethnic groups, including:
- People of African descent,
- Including African-Americans (among whom 1 in 12 carries a sickle cell gene)
- Hispanic-Americans from Central and South America
- People of Middle Eastern, Asian, Indian, and Mediterranean descent
- Approximately 2000 infants are born annually with the disease
- SCD affects approximately 200,000 Americans annually
- 1 in 365 African Americans
- 1 in 13 African Americans have the traits (carrying only 1 of the gene, S)
(CDC August 2017, Mayo Clinic)
Economics of SCD
10 years ago; Medical expenditure for children with SCD averaged $12,000 yearly for those with Medicaid and $15,000 yearly for those with commercial insurance.
There were also 113,000 hospitalizations costing over $500,000 paid by Medicare and Medicaid of which 75% of the visits were in adults and each with at least 3 Emergency Room visits per year. Children with SCD miss a minimum of 18 days per school year
Total healthcare costs nowadays for SCD is estimated at $2billion per year.
According to (David A.N et al 2018), ‘In Nigeria, the prevalence of SCD is 20–30/1000 live births. The burden of the disease has reached a level where it contributes 9–16% to under-five mortality in many West African countries. Hemoglobinopathies alone represent a health burden comparable to that of communicable and other major diseases’
Causes of SCD
Healthy red blood cells are round, and they move freely through small blood vessels to carry oxygen to all parts of the body. In SCD, the red blood cells become hard and sticky and look like a C-shaped called a “sickle” and they are not able to carry enough oxygen. When they travel through small blood vessels, they get stuck and clog the blood flow.
The sites most often affected by clogging or stacking of sickle cells are found in the lungs, liver, muscle, bone, spleen, eyes, and kidneys and other parts and tissues of the body: explains why patients complain of a lot of pain in these areas as the symptom of the disease.
Patients also have immunity suppression which leads to infections by bacteria, and viruses.
Symptoms of SCD includes;
- Excessive fatigue, irritability from anemia
- Jaundice (yellowing of eyes and skin), may also include retina damage
- Swelling and pain in hands, and feet, Pain in chest, back arms and legs, also damage of hip
- Frequent infections,
- Pain and problems in the spleen, (Nausea, vomiting, diarrhea)
- Delayed growth
- Stroke (20–30% of children stroke, 23% in African Americans)
- Genitalia (priapism, a constant erection, in which severe episodes may lead to impotency)
Treatment of Sickle Cell Anemia
Treatment of SCD pain or crisis is done in the following manner:
Rehydration: with IV fluids, helps Red blood cells return to normal shape
Also Read: The ELMA Group of Foundations Commits ZAR 2 Billion to COVID-19 Response in Africa
Drugs:
- Antibiotics: used to treat underlying infections. In some cases antibiotic prophylaxis, penicillins are recommended.
- Pain medications to treat acute pain
- Hydroxyurea: helps increase production of red blood cells
Immunization: Pneumococcal and Meningococcal vaccines have drastically reduced the rate of infections in SCD
Blood transfusion: improves oxygen and nutrients needed
Supplemental oxygen by mask makes breathing easier and improves oxygen levels in the blood
Bone marrow transplant: for severe complications and matching donors.
Prevention
- Genetic counselling and testing (better before marriage and at pregnancy) can help prevent the likelihood of passing gene to your child
- Preventing infections can be achieved by practising simple hand washing techniques at every opportunity. Hand sanitiser gels and wipes are also available and affordable
- Immunisation is very important and one must assure shots and records are current to cut down on the rate of common infections.
- Re-hydration with fluids at all times is essential.
- Avoid staying in places with low concentration of oxygen, e.g. unpressurised air planes, or high altitudes
For more information about SCD, please speak to your Pharmacist or Doctor.
Article by Kunle Tometi a Pharmacist, Entrepreneur and Public Health Advocate.
Ref:
- https://en.wikipedia.org/wiki/Sickle_cell_disease.
- Mayo clinic https://www.gstatic.com/healthricherkp/pdf/sickle-cell-anemia.pdf
- CDC https://www.cdc.gov/ncbddd/sicklecell/data.html
- Sickle cell Disease: Public health agenda & Social, Economic and Health implications by CDR Althea M Grant, PhD September 2012
- www.score_international.org/resources/conference_presentations
- Overview of the management & prognosis of sickle cell disease, Joseph Palermo, D.O.
- Economic impact of sickle cell Hospitalization. R Singh, Ryan Jordan and Charin Hanlon
- www.bloodjournal.org/content/124/21/5971
- Prevalence and impact of sickle cell trait on the clinical and laboratory parameters of HIV infected children in Lagos, Nigeria
Prevalence and impact of sickle cell trait on the clinical and laboratory parameters of HIV infected children in Lagos, Nigeria.
aYo Zambia CEO, Andrew Nkolola
microinsurer aYo Zambia has has just launched Family Cover, which allows Zambians to get hospital and life cover for themselves as well as their direct and extended families without filling in a single form. The new product will also see all premiums collected (and claims paid) via the MTN Mobile Money (MoMo) platform. Until now, aYo has offered hospital and life cover to individuals only through two insurance products, ‘Send with Care’ and ‘Recharge with Care’. But a growing market demand for insurance for the whole family prompted the company to create the new Family Cover product, which allows policy holders to add up to seven people, including themselves.
“As of today, we have had over 3.5 million customers purchase cover to protect themselves for hospitalisation in the event of illness or injury, or loss of life,” said aYo Zambia CEO Andrew Nkolola. “But many of our customers have been asking us: ‘How will we safeguard our children and families if something happens to them? We don’t want benefits only when something happens to us.’ We realised it was a huge gap in the market and have responded accordingly.”
As with aYo’s existing products, Family Cover customers must maintain active Mobile Money (MoMo) accounts to pay premiums and claim. This will allow them to insure up to three other family members per benefit, for a total of seven people. Family Cover allows policyholders to add extended family as well as direct relatives between the ages of 1 and 69.
Customers can enrol family members by dialling the USSD code *296* and selecting the Family cover option to enrol and manage cover. As with ‘Send with Care’ and ‘Recharge with Care’, valid Family Cover claims are paid directly to the claimant’s mobile money wallet without any hassles.
aYo was recognised as the Most Innovative Ecommerce Product in Zambia by the Institute of Finance and Economics in October, and followed that up in November with three awards at the Pensions and Insurance Authority Industry awards: Microinsurance product of the year, Best Customer Centric Experience, and Product and Service Innovation of the Year.
“The market perception of insurance in general is changing. Today, every Zambian consumer can purchase insurance on the go, using their mobile phones. Offerings like Family Cover provide a much-needed social safety net that helps vulnerable people and particularly people with low incomes to stay afloat when the unexpected happens,” said Nkolola.
mPharma, Africa’s leading patient-centered technology-driven healthcare company, has acquired the majority stake in HealthPlus, the leading pharmacy chain in Nigeria. mPharma and the former investor, Alta Semper, have signed an agreement leading to the acquisition of a majority stake in the HealthPlus Group.
According to the Chief Executive Officer and Co-founder of mPharma, Gregory Rockson, the acquisition is in line with the company’s mission to build an Africa that is in good health by delivering life-changing healthcare services and drugs to improve health outcomes for patients. He stated that the acquisition of the HealthPlus Pharmacy chain by mPharma complements mPharma’s deep commitment to increasing patient access to affordable and quality healthcare in Nigeria.
“mPharma is deepening its long-standing commitment to Africa by reimagining primary healthcare in some of the most vulnerable communities on the continent. We continue to transform community pharmacies into primary care centers to provide affordable and accessible healthcare to all patients so they can live not just longer but healthier lives. We are optimistic about the future of healthcare for Nigerians through the acquisition of HealthPlus.”, said Rockson.
In her remarks on the acquisition, Afsane Jetha, Co-founder and CEO at Alta Semper Capital, said: “We are delighted about HealthPlus’ partnership with mPharma. We have a strong conviction in mPharma’s strategy of revolutionizing primary care across Africa and believe mPharma is the ideal steward for HealthPlus’s next chapter of growth. We believe mPharma’s vision is consistent with that of HealthPlus’s shareholders and employees, and we are enthusiastic to support the business through a relationship with mPharma going forward”.
While mPharma plans to continue to keep and strengthen HealthPlus as Nigeria’s leading pharmacy brand in Nigeria, the acquisition will also provide expansion opportunities for mPharma within Nigeria and a platform to expand mPharma’s mutti pharmacy retail footprint across the continent through its fast-growing QualityRx program. Powered by mPharma’s proprietary Bloom software, HealthPlus will provide patients access to affordable primary care services within its pharmacies, in addition to affordable and quality medications it currently retails across 12 states in Nigeria. The HealthPlus pharmacy chain will also launch mutti®, mPharma’s health membership program, which will provide both existing and new customers with discounts, interest-free “heal-now-pay-later” plans, free health screenings, and other primary care services.
By combining HealthPlus pharmacies with mPharma’s growing portfolio of partner mutti pharmacies and GoodHealth shops (PPMVs),mPharma’s network will grow from 224 to over 320 health facilities in Nigeria and will provide care to more than 100,000 Nigerians each month.
Chantel Cooper, CEO of The Children’s Hospital Trust (Image: Supplied)
Chantel joined the Children’s Hospital Trust in 2013 as the Head of Fundraising and Communication and was appointed as CEO in 2019. For her, 2020 was a year that reinforced the importance of the core purpose of the Trust and the difference the organisation wants to make in the lives of children. “Our cause is driven by the need to make a difference in the lives of sick and injured children. We are people who work together to save the lives of the children who matter. We all have a purpose!” she says.
Sharing excerpts from her journey, Chantel says:
“My purpose in life is to serve those who are most vulnerable: women and children. My career was driven by my passion to make a real difference in the lives of women and children. When I was 18 years old, I volunteered for an organisation that provided support for women who had been raped. While volunteering, I started working with women in rural areas in the Eastern Cape where we found opportunities to grow their businesses.
“My passion for women led me to Cape Town where I became Director of Rape Crisis Cape Town when I was 27 years old. After the birth of my two children, I moved to an organisation called St Joseph’s Home for chronically Ill Children. St Joseph’s is a step-down facility for tertiary hospitals like the Red Cross War Memorial Children’s Hospital. It was a profound move for me as I was able to work with children who inspired me.
“One of the most valuable lessons I learnt is the power of love. You can offer a child the best healthcare in the world, but what a child wants most is their parents to love them and be by their side. This is the value I most appreciate about the Red Cross War Memorial Children’s Hospital and my past experiences. This hospital believes in child-centered care and knows that a child heals when their parent or caregiver is by their side – even during the COVID-19 pandemic. All other hospitals had restricted access to patients, but the presence of a parent is imperative to their sick or injured child’s healing.”
Overcoming Adversities
“The COVID-19 pandemic taught our team that life can change in a blink of an eye and that we need to be prepared for all possibilities. The pandemic hit the world with such speed and velocity that we had no choice but to find a way to not only sail through the storm but also find ways to get out of the situation stronger than before.”
Chantel also states that 2020 provided the Children’s Hospital Trust with the opportunity to learn extraordinary lessons that they would not have normally had the opportunity to learn and some of these include:
- The value of deep listening and the importance of demonstrating kindness.
- Working in collaboration created the opportunity for meaningful impact for our beneficiaries.
- Opportunities do exist during challenging times; positivity exposed the opportunities.
- Adapting to change during uncertain times helped to build a resilient team.
“Our Trust team demonstrated ingenuity, compassion, resilience, commitment, and fortitude during a very difficult time. As a result, we surpassed our goals, and this enabled our organisation to reach more children and families. We are grateful for the contribution from every individual,” adds Chantel.
“Walking through the corridors of a children’s hospital during a crisis gave perspective on the real value of care, kindness, and collaboration. While children were not the face of the COVID-19 pandemic, the Social Work Department experienced first-hand the profound impact the pandemic had on children’s health and well-being.
“Unemployment, food insecurity, child safety and schooling were common concerns for many patients and their parents who entered the doors of the Hospital. The Red Cross War Memorial Children’s Hospital values patient and family-centred care which includes care for the whole family from a holistic perspective.
“In response to the needs of the families, the Trust secured funding to enable the social workers to provide additional counselling services and material support such as the provision of food, hygiene, and home-schooling supplies to vulnerable families when children were discharged from the Hospital.” Read more on the Family Care Project here.
Redefining Excellence
The core to achieving our vision is upholding our values of Integrity, Accountability, Kindness, Dynamism, and Collaboration in every aspect of our work. The Trust has a sound financial record in administration and good governance. For the past 28 years, we have raised funds to address many pressing needs, but much has yet to be done. With the help of many donors, we continue to give hope and healing to our little ones who need it most.
The Trust raises funds for the upgrade and expansion of the Hospital’s buildings, the purchase of state-of-the-art medical equipment, and new medical treatment projects and funds the training of medical professionals across Africa – ensuring that the Hospital not only retains its world-class stature but is able to continue providing life-changing and life-saving care for children.
The Trust relies on donations to fund these needs. When you donate to the Trust, 100% of your donation goes towards funding projects that change children’s lives (and the lives of the people who love them). The operational costs of the Trust are funded from an endowment, so your generous contributions are never used to cover administration costs.
Donate to the Children’s Hospital Trust today! www.childrenshospitaltrust.org.za
