SICKLE CELL ANEMIA

Sickle Cell Anemia is an inherited disorder in which red blood cells (RBC's) are abnormally shaped. A hereditary disease caused by mutant recessive gene. This abnormality can result in serious infections, chronic anemia, and damage to body organs.

Dadra and Nagar Haveli is lies near the west coast and consists of two separate parts. Dadra is surrounded by the state of Gujarat and Nagar Haveli lies on the borders of Maharashtra and Gujarat. As Dadra and Nagar Haveli is surrounded by Gujarat and Maharashtra states and both states having prevalence rate is around 34% and 33% which is highest rate in India. Dadra and Nagar Haveli comprise of 1 district, 1 block and 72 villages and according to 2011 census it has a total population of 343709 , the tirbals constitute 51.95 % of the total population of the territory. The main tribes are Dhodia, Kokan and Varli with small groups of Koli, kathodi, Naika and Dubla scattered over the territory.

Sickle cell anemia disease is most common in the tribal community like Dhodia, Kokana, Varli, Kolcha, Kothvadia, Vasava, Gamit, Tadavi, Koli, Kathodi, Naika and Dubla etc. In U.T of Dadra and Nagar Haveli, there are very specific concentration need to be address the serious issue of sickle cell anemia to prevent the morbidity, mortality and reduce prevalence rate.

Hence in 2013, the sickle cell anemia control programme has been proposed and administration has approved to rollout in the U.T of Dadra and Nagar Haveli. Sickle Cell Anemia Control Programme was launched in September 2013 in the U.T of Dadra and Nagar Haveli. Sickle Cell Anemia Counseling center was started in 1st June 2014 at Shri Vinoba Bhave Civil Hospital for Counseling of Indoor patients and OPD patients.

Goal

Decrease Sickle Cell Disease childbirth by marriage counseling.
Prevention of death from Sickle Cell Crisis.
To improve health status and quality of life of sickle cell anemia patients.

Components

Screening for Sickle Cell by Health staff.
Establish Counseling Centers for Marriages and Treatment.
Treatment of sickle cell disease patient through PHCs and CHC and District Hospital.
Awareness Campaign.
Convergence of SCA activity with other programs.
Preparing database for Sickle trait and disease patients.

Strategies

Screening of entire tribal population to understand actual burden of the Sickle Cell disease. Target population is Adolescent (up to 18 years male/female), Antenatal mothers & Spouse of positive antenatal mother.
Supportive treatment, follow up and counseling to reduce morbidity and mortality.
Reduction in crisis episodes.
Saving lives through referral treatment and specialized hospital care.
Community awareness and sensitization of the population.
Training and capacity Enhancement.

Screening

Screening started at all PHCs, CHC and SVBCH with DTT test.
Screening of all the tribal children registered at Anganwadi, Schools and Colleges.
Mass screening at village level with the help ASHA worker and ANM of the concerned PHC.
All the tribal pregnant women with anemia are screened for Sickle Cell Anemia and if found positive their husbands are screened for Sickle Cell Anemia. If both are found positive then counseling for prenatal diagnosis is done.
for New born screening and prenatal diagnosis at Shri Vinoba Bhave Civil Hospital, CHC and all PHCs.
All DTT positive for Sickle cell anemia will be diagnosed by HPLC test for Sickle cell Trait and Disease.
At present department does not have HPLC machine but department will purchase HPLC machine shortly in the next financial year.

Counselling Services

Counselling Services have been started at Primary Health Centres, Community Health Centre and Sub-district Hospital(Shri Vinoba Bhave Civil Hospital) also.

Treatment

Regular supply of Tablet Folic acid, Soda-bicarbonate and Analgesic to the disease patients.
Patients with frequent crisis episodes, tablet Hydroxyurea will be given for reduction in crisis episodes.
Supply of free Blood and Blood component to the sickle cell anemia patients.
Regular follow up of disease patients every 3 months and maintaining their health cards.
All Sickle cell disease patents is targeted for pneumococcal vaccination.

Community Awareness and Sensitization

For Awareness and Sensitization, Awareness lectures were given in the schools, colleges and during mass screening camp in villages.

Training and Capacity Building

Grass root level workers like ANM, ASHA workers of PHC are aware for Sickle cell anemia disease through training.
Hands on training of DTT test for Sickle cell to all the Lab. technicians of PHCs, CHC and VBCH.