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Feature Article of Wednesday, 16 January 2013

Columnist: Boakye-Yiadom, Becky

Sickle Cell in Ghana: A Public Health Concern

It is important to know if you carry the sickle cell disease. According to the Ministry of Health, Ghana, recent studies indicate that about 2% of Ghanaian newborns are affected by sickle cell disease. Sickle cell disease refers to a group of inherited red blood cell disorders. It is one of the most common genetic diseases in the Ghana. Normal red blood cells are round like doughnuts, and they move through small blood tubes in the body to deliver oxygen. Sickle red blood cells become hard, sticky and shaped like sickles used to cut wheat. When these hard and pointed red cells go through the small blood tube, they clog the flow and break apart. This can cause pain, damage and a low blood count or anemia.

People who inherit sickle cell gene from one parent and a normal hemoglobin gene from the other parent have a condition called sickle cell trait. Sickle cell trait is different from sickle cell disease. People who have sickle cell trait don't have the disease, but they have one of the genes that cause it. Similar to people who have sickle cell disease, persons with sickle cell trait can pass the gene to their children.

The pain from sickle cell crisis can be acute or chronic, but acute pain is more common. Acute pain comes suddenly and can range from mild to very severe. The pain usually lasts from hours to a few days. Chronic pain often lasts for weeks to months. Chronic pain can be hard to bear and mentally draining. This pain may severely limit daily activities, work and education. Almost all people who have sickle cell disease have painful crises at some point in their lives. Some have these crises less than once a year. Others may have 15 or more pain crises in a year.

The following frequently asked questions and responses may be helpful:
1. How can one be tested? A simple, painless blood test called the hemoglobin electrophoresis can be done by your doctor or local sickle cell foundation.
2. When should you be tested? Get tested now for sickle cell! If you are of child-bearing age, you and your partner should be tested immediately so that you can make informed family planning decisions.
3. How can you help? If you do not have sickle cell disease, you can help those who battle this disease by donating blood to your local Red Cross, clinics and hospitals near you. Be a local advocate. I am, because I have lost friends and family members so painfully through this disease. Sickle cell patients often need multiple blood transfusions to alleviate the painful crisis episodes.
Supporting local and national efforts to increase awareness about the Sickle Cell Disease (SCD) is a significant public health burden in Ghana. We need to develop a system that will help build a database of people with SCD. This will be helpful in addressing issues related to their health, educational and psycho-social needs of all affected persons and families. Public health professionals and other health practitioners need to collaborate in educational efforts to make more people aware of this important public health concern. People with sickle cell disease and those with sickle cell trait and their families and friends deserve an effective support system.
Becky Boakye-Yiadom
Department of Social and Public Health
Ohio University, Athens, OH, USA

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