Doctors call for better management of sickle cell anaemia patients

Lack of adequate information among healthcare workers is contributing to misdiagnosis and delayed treatment for children with sickle cell anaemia.

This is largely because the condition does not manifest in one clinical presentation and requires multiple tests for proper diagnosis.

DANGER

“In some children it might present as fever and one may assume that it is malaria or pneumonia.

“There is delayed diagnosis by health workers due to lack of awareness on the condition and we hope that collaborative guidelines can be developed to assist in addressing this issue,” said Prof Chite Asirwa, an oncologist at the Moi Teaching and Referral Hospital, at a recent sickle cell disease stakeholder meeting in Eldoret.

Delayed diagnosis may lead to health complications and even death.

The World Health Organisation estimates that about five per cent of the world’s population carries traits for haemoglobin disorders, mainly sickle-cell disease and thalassaemia, which are passed on to offspring by generally healthy patients.  An estimated 300,000 babies with severe haemoglobin disorders are born in the world every year.

“Most patients don’t live past age 25. They succumb to complications of the disease, yet most of these deaths can be prevented.

“Vaccination, therapy and medication can reduce cases of hospitalisation and painful crisis (when sickle-shaped red blood cells obstruct blood vessels and restrict blood flow to body organs, leading to pain, death of cells and damage to organs),” observed the specialist, who also serves as the oncology and haematology programme director for the Academic Model for Proving Access to Healthcare (Ampath).

According to Dr Felistus Makokha, a paediatrician in Bungoma County, most public health facilities in western Kenya where the disease is prevalent lack haemoglobin electrophoresis machines to perform confirmatory tests.

EARLY SCREENING

The experts also called for early screening for sickle cell patients to help reduce health complications linked to the condition.

Prof Asirwa observed that early screening would ensure that patients do not suffer from permanent kidney damage, stroke or other chronic conditions due to delayed diagnosis and in turn, delayed medical intervention.

“Most public hospitals do not offer prenatal screening, which could help identify patients for early intervention and save them from damaging health complications,” he said, adding that there is need to raise awareness about the condition and formulate county policies to help patients manage the condition.

“Most patients and their families do not know about simple interventions such as hydration, managing fever or what to do when the spleen is enlarged.

“Community health workers can help by creating awareness about the condition, screening families at their homes and referring them for treatment and sharing information about how to care for patients with sickle cell anaemia,” he explained.

Dr Makokha added that vaccines for pneumonia and meningitis could help improve the wellbeing of sickle cell anaemia patients and enable them engage in economic activities.

She added that access to medicines such as hydroxyurea which increase foetal haemoglobin that doesn’t sickle and Pen V an antibiotic to fight bacterial infections in sicklers would go a long way in helping to reduce complications and helping patients live long, productive lives.

The doctors also noted that myths and misconceptions were slowing strides against the disease.