Sickle Cell In Nigeria
Certainly, Sickle Cell Disorder is a global health problem with psycho-social implications. Unfortunately, Nigeria has the largest population of people with sickle cell disorder, with about 150,000 births annually. The incidence of sickle cell anemia in Nigeria is among the highest in the world, with more than 100,000 Nigerian children being born each year with the disorder. Those with the disease suffer a higher than average frequency of illness and premature death, especially in infancy. The condition can also cause heart attacks, kidney failure, severe infections and sudden death. Statistics available show that over 40 million Nigerians are carriers of the “S” gene. Indeed, this number far exceeds the total population of every other affected African country and several of them put together. Despite the large number of people with sickle cell disorder, the Nigerian society in general still has a negative image of SCD, and reported negative perceptions and attitude
About Sickle Cell
Sickle-cell anemia (also known as sickle-cell disorder or sickle-cell disease) is a common genetic condition due to a hemoglobin disorder – inheritance of mutant hemoglobin genes from both parents. Such haemoglobinopathies, mainly thalassaemias and sickle-cell anemia, are globally widespread. About 5% of the world’s population carries genes responsible for haemoglobinopathies. Each year about 300 000 infants are born with major hemoglobin disorders – including more than200 000 cases of sickle-cell anemia in Africa. Globally, there are more carriers (i.e. healthy peoplewho have inherited only one mutant gene from one parent) of thalassaemia than of sickle-cell anemia,but the high frequency of the sickle-cell gene in certain areas leads to a high rate of affected newborns.
Frequencies of the carrier state determine the prevalence of sickle-cell anaemia at birth. For example, in Nigeria, by far the most populous country in the subregion, 24% of the population are carriers of the mutant gene and the prevalence of sickle-cell anaemia is about 20 per 1000 births. This means that in Nigeria alone, about 150 000 children are born annually with sickle-cell anaemia. The sickle-cell gene has become common in Africa because the sickle-cell trait confers some resistance to falciparum malaria during a critical period of early childhood, favouring survival of the host and subsequent transmission of the abnormal haemoglobin gene. Although a single abnormal gene may protect against malaria, inheritance of two abnormal genes leads to sickle-cell anaemia and
confers no such protection, and malaria is a major cause of ill-health and death in children with sickle-cell anemia. There is increasing evidence that malaria not only influences outcome but also changes the manifestations of sickle-cell anemia in Africa.
The public health implications of sickle-cell anemia are significant. Its impact on human health may be assessed against the yardsticks of infant and under-five mortality. As not all deaths occur in the first year of life, the most valid measure is under-five deaths. An increasing proportion of affected children now survive past five years of age but remain at risk of premature death. When health impact is measured by under-five mortality, sickle-cell anaemia contributes the equivalent of 5% of underfive
deaths on the African continent, more than 9% of such deaths in west Africa, and up to 16% of under-five deaths in individual west African countries.