Introduction
Sickle Cell Anemia (SCA) is one of the conditions whose treatment and management is a challenge; the cost of management is high, and treatment is also expensive and rare. When discovered, the literature indicates a certain age at which affected persons could not live past. However, due to emerging discoveries, there are therapeutic approaches that have made it possible for people affected to even live past the age of 50s. However, it is indicated that there have been disparities regarding how SCA has not been contained in developing nations, especially Sub-Saharan Africa, which has continued to record high morbidity and mortality rates from SCA. Such an n experience is a stark realization that access to health care seems to be controlled by the socioeconomic status of a place. World Health Organization indicates that people should not be vulnerable because of their socioeconomic status. However, with SCA, one of the challenges is the cost of managing the disease. Significantly, before any developments in Sub-Saharan Africa regarding the management of SCA, what is needed is an awareness program and the development of traditional anti-sickling approaches.
Research Review on SCA Management in Sub-Saharan Africa
The statistics in Africa regarding morbidity and mortality of SCA differ from other nations. Considerably, in certain parts of Africa, the situation is a replica of what used to be the case in Europe when SCA was discovered. According to Diop and Pirenne (2021), ’50–90% of SCA children will die in Africa before the age of 5.’ This was the case when the life of a person living with SCA had to be analyzed based on age. Investigating how Europe and other developed communities contain the morbidity and mortality challenges associated with SCA is essential.
There are other cheaper but less ineffective methods of managing SCA. Diop and Pirenne (2021) reveal that SCA patients are given medications to manage pains in many parts of Africa. This is not sustainable because these people are weakened by the various painkillers administered to them. Many parents in Africa would seek specialized treatment of the affected persons when there is severity. The problem with this is that when it is severe, there could be more damage to body organs, escalating the mortality rates. Also, there is that feeling of ‘witchcraft.’ Diop and Pirenne (2021) argue that the misconception that it is a cursed disease slows down the treatment of persons living with SCA in Sub-Saharan. When there is such a misconception, vulnerable children who cannot make choices tend to suffer because of the ignorance of their parents. This is a case of ignorance.
However, there is the issue of medication cost for SCA management. With the emergence of medical discoveries, Abboud (2020) indicates that effective approaches such as chronic transfusion therapy and Stem Cell transplant have been embraced in handling SCA. These approaches have proved to be effective. Chronic transfusion therapy offers a reprieve to the affected person because the transfused blood is free from the sickled red blood cells. This is ideal for managing the associated pain. Stem Cell Transplant is a sustainable and long-term treatment for the condition. However, it is expensive since it is one of the rarest ways of treatment. In Sub-Saharan Africa, only some nations have such technology. The other method of managing SCA is through Hydroxyurea; however, the cost also makes it inaccessible for a low-cost living family. Abboud (2020) indicates that the average cost for complete Hydroxyurea care is approximately $100. Such an amount is unattainable for an average family in Sub-Saharan Africa.
Two issues are evident in the case of Sub-Saharan Africa regarding its management of SCA. First, there is ignorance, where there have been misconceptions about the cause of disease. When there are allegations of a curse as the source of the SCA conditions, this implies that these parents are likely to resort entirely to spiritual treatment as an alternative. Spiritual development could be ideal because of the need for the affected person to have the right mentality and emotions, but thus needs to be augmented by medical interventions. The ideal way to define the situation in Sub-Saharan Africa and an individual approach to handling SCA is the case study of Cuba. Despite its economy, Cuba is one of the countries with a cost-effective healthcare system. Marcheco-Teruel (2019) reveals that cases of SCA carriers are 1 out of 33 births in Cuba; however, in the 1980s, it was 1 in 1600 births. These changes in Cuba were necessitated by adopting the SCA prevention program. Parents were screened on genetic orientation to determine the propensity of having an SCA-affected child. The parents were advised about the challenges and demerits of raising a person living with SCA. Genetic counseling had been ideal, and there were parents who decided to terminate the pregnancy because of such conditions. This is a proactive way of ensuring society is free from SCA incidences. However, all this required a change of oerece0tion. The Sub-Saharan communities should change their perception; this happens through awareness programs.
The Sub-Saharan governments need to empower alternative medicine platforms. Yembeau et al. (2022) indicate that specific communities use medicinal herbs in the symptomatic management of the condition. Some of these herbs are used to may treat chest pains or manage the body temperature of the affected individual. However, these herbs’ effectiveness level may be lower because of the rudimentary form in which it is administered. Such alternatives must be implemented to ensure that people living with SCA live longer, like in the developed world. A case study in Cameroon substantiates the information presented in this case. According to Lubega, Osingada, and Kasirye (2021), traditional healers, out of default or by design, tend to use plants that have alkaloids and polyphenols. These substances are crucial in enhancing antioxidant activity in the body. However, in the case of the Cameroon context, there needs to be more government support. The healers operate within an amorphous pharmacology environment. These healers have been misperceived as persons pursuing witchcraft in some instances, and as such, even society needs to be more severe about this valuable alternative approach.
Conclusion
Sickle Cell Anemia is one of the diseases requiring awareness and adoption of alternative management methods for developing nations. Cuba has managed the situation because of a change in mentality regarding the need for a community that has reduced incidents of SCA. This happened with few resources, unlike other alternatives such as Stem Cell Transplants. Also, the role of alternative medicine, like herbs, should be addressed. African governments could seek assistance in developing these medicinal herbs to handle the SCA incidence rates. SCA cannot be a concern in the current setting because of issues associated with ignorance or inability to utilize the available alternatives, like in the case of herbs as portrayed in the context of Cameroon.
References
Abboud, M. R. (2020). Standard management of sickle cell disease complications. Hematology/Oncology and Stem Cell Therapy, 13(2), 85-90.
Diop, S., & Pirenne, F. (2021). Transfusion and sickle cell anemia in Africa. Transfusion Clinique et Biologique, 28(2), 143-145.
Lubega, M., Osingada, C. P., & Kasirye, P. (2021). Use of herbal medicine by caregivers in the management of children with sickle cell disease in Mulago National Referral Hospital-Uganda. Pan African Medical Journal, 39(1).
Marcheco-Teruel, B. (2019). Sickle cell anemia in Cuba: Prevention and management, 1982–2018. MEDICC review, 21, 34-38.
Yembeau, N. L., Biapa Nya, P. C., Pieme, C. A., Tchouane, K. D., Kengne Fotsing, C. B., Nya Nkwikeu, P. J., … & Telefo, P. B. (2022). Ethnopharmacological Study of the Medicinal Plants Used in the Treatment of Sickle Cell Anemia in the West Region of Cameroon. Evidence-Based Complementary and Alternative Medicine, 2022.
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