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.
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
- 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.
- 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.
- 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
- 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
- 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.
AstraZeneca launches Africa Health Innovation Hub to increase access to healthcare
AstraZeneca, a leading global pharmaceutical company, launched the Africa Health Innovation Hub today. This ground-breaking initiative highlights the company’s commitment to healthcare equity and fostering partnerships with a range of stakeholders, including governments, healthcare societies, academia, healthcare providers and patient advocacy groups, to better improve patient outcomes. Building on AstraZeneca’s work in Africa, the hub aims to use the latest science and technology to improve access to healthcare for patients on the continent.
The Africa Health Innovation Hub is the latest in the global A. Catalyst Network, a connected array of over 20 hubs worldwide. This network seeks to tackle current healthcare challenges through collaborative innovation, promote affordable and equitable healthcare access, and amplify patient-centred innovation through strategic alliances within the healthcare ecosystem.
Last year, AstraZeneca joined the WEF Edison Alliance, a public-private partnership that aims to improve the lives of 1 billion people through digital inclusion by 2025. The partnership reinforces our commitment to harnessing digital innovation to drive inclusion and equity across the healthcare ecosystem, therefore, will also be a strong facilitator of the Africa Hub.
Gagan Singh, Country President, African Cluster, AstraZeneca, stated, “AstraZeneca aims to strengthen and future-proof health systems across the whole patient journey, ensuring everyone has equitable and affordable access to the life-changing healthcare solutions they need, regardless of where they live. The launch of the Africa Health Innovation Hub is a significant step in our goal to unlock digital transformation and innovation in health across the continent, paving the way for patient-centric digital health solutions that leave no one behind. By working with partners across the continent, we are nurturing local talent and making quality health care more accessible for all.”
Partnering to bring our purpose to life
In Africa, two major new partnerships will form the backbone of the Hub in its initial phases:
- In South Africa, AstraZeneca is partnering with MEDSOL AI SOLUTIONS to help promote the use of AI in the detection of disease through a state-of-the-art Wi-Fi ultrasound probe that can detect breast cancer in seconds. The Melusi Breast AI rapid detection app will be rolled out in rural clinics to help in early detection of the disease, supported by a dedicated referral system so that women with positive detection of breast cancer can be offered a quicker turnaround time for therapeutic intervention.
Dr Kathryn Malherbe (PhD), CEO & Founder of MedSol AI Solutions said, “Medsol AI is excited to be leading one of the inaugural projects of the Africa Innovation Hub, with support from AstraZeneca. Breast cancer is a devastating disease, with many women in our communities only able to access late-stage diagnoses. The Melusi Breast AI project will enable us to leverage technology and innovation to improve early diagnostic detection rates and patient outcomes in local clinics, ultimately saving lives.”
- In Kenya, the company is expanding an already successful collaboration with Tricog Health Limited. After a few years of piloting an AI technology that connects ACS patients to health professionals and route them to the appropriate facilities, enabling early cardio-renal complications to be addressed in India, the African hub aims to enhance early diagnosis and treatment of Heart Failure using Tricog’s InstaECG AI tools for rapid diagnosis, reducing mortality rates and improving quality of life.
Dr. Charit Bhograj, CEO & Founder Tricog Health Limited added, “non-communicable diseases, including heart disease, are on the rise in Kenya and across Africa, and we know that the earlier these conditions are diagnosed, the better chance it is for patients to continue to live long healthy lives. By investing in digital health technology, the Africa Health Innovation Hub is enabling the use of advanced AI to screen and diagnose patients remotely, bringing high-quality health tools to people no matter where they live.”
Another partnership initiated last year and will officially form part of the Africa Health Innovation Hub is the Fuel Africa programme, launched by Futurize. This is the largest healthcare entrepreneurship programme on the continent, bringing together the brightest minds across universities in Sub-Saharan Africa to address some of Africa’s most pressing challenges in healthcare. For the second year in a row, AstraZeneca’s A. Catalyst Network partnered with Futurize to reinforce our strong commitment to fostering innovation in the continent by developing local talents.
Official kick off to AstraZeneca’s health innovation hub in Africa
The official launch event – which marked the launch of the hub and the kick off of the Medsol AI partnership – took place at the Daspoort Poli Clinic in Pretoria, South Africa, where healthcare practitioners were able to demonstrate the use of the Melusi Breast AI device in a community clinic setting, which is one of the first points of contact for clinical breast examinations and breast cancer screening for patients.
The Africa Health Innovation Hub will also invest in building local talent, promote policy change for cancer screening, close the gaps in healthcare access and improve the quality of life for patients in the African region, particularly in rural and underserved communities. These objectives are aligned with the four pillars of AstraZeneca’s A. Catalyst Network: Education and Awareness, Early Diagnosis and Referral, Connectivity and Technology, and Data Generation.
aYo Zambia launches Family Cover in response to ‘overwhelming’ demand
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 acquires majority stake in HealthPlus
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.