Gujarat's Award Winning Sickle Cell Anemia Control Program

by P.K Taneja, IAS

Principal Secretary and Commissioner

Department of Health

Sickle Cell Anemia Control Program of Gujarat state was honored by “Prime Minister Award for Excellence in Public Administration” by Department of Administrative Reforms and PublicGrievances, Government of India

Introduction

Sickle Cell Anemia (also known as Sickle Cell Disorder or Sickle Cell Disease) is a genetic disorder, where the blood cells contain abnormal sickle-shaped hemoglobin cells called sickle hemoglobin (HbS) which cause blockage of the blood vessels leading to severe health complications.

The highest frequency of occurrence of the Sickle Cell Disease is in tropical regions, particularly Sub-Saharan Africa, India and the Middle-East. In India, the prevalence of Sickle Cell Anemia is highly common in the tribal belt of the central and southern parts.

The public health implications of Sickle Cell Anemia are significant leading to poor quality of life, lower life expectancy and higher rates of infant mortality.

Sickle Cell Anemia in Gujarat

Gujarat is one of the few States in India which have incorporated the Sickle Cell Anemia Control Programme in their existing health services. Initially this program was started in five districts of South Gujarat viz. Surat, Tapi, Navsari, Valsad and Dang on a PPP mode with the help of an NGO named Valsad Raktadan Kendra. In 2008, the activities under this program were replicated in the rest of the tribal districts viz. Bharuch, Narmada, Vadodara, Panchmahal, Dahod, Sabarkantha and Banaskantha aided by the Indian Red Cross Society, Ahmedabad. Thus, the entire tribal belt of eastern Gujarat was covered from Ambaji to Dang.

Sickle Cell Disease does not have a cure as of now; therefore any strategy to deal with the disease should focus on prevention, early diagnosis. The Sickle Cell Anemia Control Programme does just that. Its focus is early diagnosis, treatment and counseling. So far more than 30 lakh tribal people have been screened for Sickle Cell Anemia.

Gujarat Sickle Cell Anemia Control Society:

In the year, 2011 Gujarat Sickle Cell Anemia Control Society was formed to integrate the various activities among different departments of Government and various NGOs for better implementation of the program. The society was formed with a goal to stop all Sickle Cell Disease child births and deaths due to the Sickle Cell Disease, by 2020.

Sickle Cell Anemia Screening

The screening under this program covers the all age group from newborns to aged people. The main target group for screening comprises of the antenatal and newborns. As this disease is genetic in nature and there is no cure for this disease, prevention is the only way to keep it away. For this, marriages between Sicklers and non-carriers or two Sicklers have to be prevented. Therefore, the Government of Gujarat has adopted a policy of screening adolescents. So the sickle cell gene can be diagnosed before marriage.

All Antenatal mothers in the tribal areas are screened for Sickle Cell Anemia at “Mamta Divas”- a special immunization day in the villages of Gujarat.The unique feature of the sickle cell anemia screening program is that it covers the whole life cycle.

Counseling

Counseling is the key objective of this program. All the Sickle Cell Traits and Sickle Cell Disease patients are counseled regularly by trained counselors. Family counseling is done at door steps. All the adolescents are counseled on marraige and pregnancy. All the tribals are given color coded cards according to their Sickle Cell Status, which help them to take a decision during marriage.

Treatment                         

All the patients are given Tab. Folic Acid regularly and Analgesics. Antibiotics and Anti malarial tablets are given as and when required. Arrangements have been made for the supply of free blood and blood products to all these patients as and when required in emergency through Regional Blood Centers and First referral Units.

As Pneumonia is the major cause of death in Sickle Cell Disease, especially in children under 5, all the Sickle Cell Disease patients are given Pneumococcal vaccine.

The Govt. of Gujarat has signed an MOU with GIOSTAR, an USA based company for creating stem cell treatment facilities at the Govt. Medical College, Surat. Stem cell transplantation will bring a hope of survival for all Sickle cell disease patients in Gujarat.

Situation after the formation of the Society

The Society has decided to complete the screening of the remaining tribal population in the next three years. To complete this task within the set time frame with the help of different NGOs; district wise screening work has been outsourced among interested, qualified and competent agencies. In the first six months, more than 11 lakh persons were screened; which is much more than previous years.