Go for pre-marital screening to know your sickle status: Expert

Nagpur: Women from high risk ethnic groups or those having a sickle cell status should get a pre-marital screening done and expecting mothers must opt for a pre-natal diagonsis to avoid birth of a child with the disease, a top medical expert said here.

According to Dr Anuradha Shrikhande, Head of Pathology department of state-run Indira Gandhi Medical College Hospital, pre-natal diagnosis for sickle cell disease is a safe procedure for both the mother and the child and the reliability of the report in best of the hands is more than 90-95 percent.

This can be achieved if women from this majority population is supported by families, communities, religious leaders and policy makers. Instead of matching horoscopes
before marriage which is a common practise prevailing in the society, know your sickling status for a smart decision of a lifetime, she said.

The female population with sickle cell status needs to be respected for confidentiality of her report so as to avoid unnecessary social stigmatisation, she felt.

Though the Maharashtra government under the Sickle Cell Control programme has made mandatory pre-marital screening for females in the reproductive age group and pregnant women but an awareness is needed among the community, Shrikhande, a Nodal Officer of Pilot Project of State Government`s Control Programme told PTI on the occasion of Sickle Cell Week being observed from Feb 28-March 6.

She said Sickle cell is a hereditary disorder associated with abnormal production of hemoglobin, sickled Hb which brings variety of clinical symptoms of varying severity.

Commonest amongst these symptoms is pain in the bones, (commonly known as vasso-occlusive crisis) anaemia and infections.

There are two forms of Sickle Cell-- Sickle Cell anaemia and Sickle Cell carriers. The carriers have an abnormal gene from any one of the parents and are therefore asymptomatic.

Where as diseased patients have abnormal genes producing sickled HB from both the parents.

If two carriers marry, there is 25 percent chances in each pregnancy that a Sickle Cell diseased child is born. All control programmes therefore focus on prevention of diseased
child in the new generation.

It is globally wide spread and 50 percent of the world population for hemoglobinpathies live in India. This abnormal gene is frequently seen in population of Maharashtra,
Chattisgarh, Gujarat, Tamil Nadu and Odisha, Shrikhande said adding Central India happens to be a hub for Sickle Cell disease and the gene frequency ranges between 13-15 percent.

With a disease birth rate per year of 260 and a carrier birth rate of around 7500, an estimated population of four lakh Sickle Cell carriers and 22,000 diseased patients are
seen in Nagpur and other parts. The disease is prevalent among low socio income group, illiterate tribal population and among the schedule castes community (SC).

Sickle cell disease produces delayed onset of menstruation in girls and delayed conception. Shrikhande said it was unfortunate that though the first case was detected in year 1910 but since than no national policy has been framed by the government to control it.

She said the initiative of Maharashtra Government in 2001 with launch of pilot project and strengthening of medical and laboratory facilities has helped both rural and urban

There are eight state-run medical institutions comprising those at Aurangabad, Mumbai, Dhule, Yavatmal, Akola and Nanded and two in Nagpur for screening female patients, she added.


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