• A total of six crore individuals have been screened for Sickle Cell Disease (SCD) against the targeted seven crore under National Sickle Cell Anemia Elimination Mission, the Ministry of Health and Family Welfare said on July 22.

• Among those screened, 2.15 lakh individuals were diagnosed with the disease and 16.7 lakh carriers identified. 

• Additionally, 2.6 crore health cards have been distributed by the respective states to the screened individuals.

• States including Madhya Pradesh, Gujarat, Rajasthan, Telangana, Karnataka and Uttarakhand have demonstrated significant progress by achieving a high percentage of screening relative to their targets. 

• The highest incidence of diagnosed cases has been reported from the states of Odisha, Chhattisgarh, Madhya Pradesh, Maharashtra and Gujarat.

• Screening for SCD is being conducted using validated point-of-care testing (POCT) kits, which ensure rapid, reliable and confirmatory results.

Sickle Cell Disease

• Sickle Cell Disease (SCD) is an inherited blood disorder that profoundly impacts patients throughout their lives, also known as sickle cell anemia.

• It affects hemoglobin, the protein responsible for transporting oxygen in the body, causing a group of genetic disorders affecting red blood cells.

• Normally, red blood cells are flexible and disc-shaped, facilitating smooth blood flow through vessels. In SCD, these cells adopt a crescent or “sickle” shape, hindering their movement and causing blockages in blood flow.

• Blocked blood flow can lead to serious complications such as stroke, eye problems, infections, and painful episodes known as pain crises.

• Sickle cell disease is inherited in an autosomal recessive manner, requiring two copies of the gene for the disease to manifest. A single copy results in sickle cell trait.

•  It is a lifelong condition, with blood and bone marrow transplant being the only known cure, while treatments exist to manage symptoms and prolong life.

• Symptoms typically appear early in life, often by 6 months of age, and include fatigue, irritability, jaundice, swelling in hands and feet, and frequent infections.

There are several types of SCD caused by different mutations in the hemoglobin genes:

i) Hemoglobin SS disease

ii) Hemoglobin SC disease

iii) Hemoglobin SB+ (beta) thalassemia

iv) Hemoglobin SB 0 (Beta-zero) thalassemia

• Less common types like Hemoglobin SD, SE, and SO usually exhibit milder symptoms.

• Populations from malaria-endemic regions such as Africa, India, the Mediterranean, and Saudi Arabia have a higher prevalence of carriers for SCD due to historical genetic adaptations.

National Sickle Cell Anemia Eradication Mission

• The National Sickle Cell Anaemia Elimination Mission was inaugurated by Prime Minister Narendra Modi on July 1, 2023 at Shahdol, Madhya Pradesh. 

• Sickle cell disease is more common in the tribal population of India.

• India has the largest density of tribal population, globally. As per Census 2011, India has an 8.6 per cent tribal population.

• The mission aims to eliminate SCD as a public health problem in India before 2047. 

• The mission will operate in a phased manner, initially targeting individuals from birth to 18 years old, expanding gradually to cover those up to 40 years old.

• It will enable access to affordable and quality health care to all SCD patients, and lower the prevalence through awareness, change of practices and screening interventions.

Objectives of the Mission:

i) Provision of affordable, accessible and quality care to all SCD patients.

ii) Reduction in the prevalence of Sickle Cell Disease through awareness creation.

iii) Targeted screening of 7 crore people till year 2025-26 in the age group of 0-40 years in affected 278 districts of tribal areas and counselling through collaborative efforts of central ministries and state governments.

Strategy

The strategy emphasizes on three pillars:

i) Health promotion - Awareness generation & pre-marital genetic counselling.

ii) Prevention: Universal screening and early detection.

iii) Holistic management & continuum of care-

a) Management of persons with sickle cell disease at primary, secondary and tertiary health care levels; treatment facilities at tertiary health care facilities.

b) Patient support system.

c) Community adoption.

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