(GIST OF YOJANA) India’s Mission-Mode Approach Against Sickle Cell Disease

(GIST OF YOJANA) India’s Mission-Mode Approach Against Sickle Cell Disease

(DECEMBER-2024)

India’s Mission-Mode Approach Against Sickle Cell Disease

Introduction:

Sickle Cell Diseases (SCD) is a genetic condition where atypical red blood cells assume a crescent or sickle form.

Impact on RBCs:

• Unusually shaped cells block blood vessels, resulting in health issues.

• Sickle cells are rigid, diminishing their ability to traverse capillaries and causing occlusions.

Key Differences:

• Normal RBCs: Biconcave, adaptable, 120-day lifespan.

• Sickle RBCs: Crescent-shaped, inflexible, 30–40-day lifespan.

Health Consequences:

• Ongoing anemia, recurrent infections, discomfort, and swelling.

• Injury to organs including the brain, liver, and lungs.

• Continuous management necessary for survival.

Types of Sickle Cell Disorders

• Normal Hemoglobin: Hemoglobin A (HbA) consists of two β-globin and two α-globin subunits.

• Sickle Cell Hemoglobin: Triggered by a mutation in the β-globin chain (HbS). Types:

• HbSS: Sickle cell anemia, the most serious variant, inherited from both parents.

• HbS-β-thalassemia: Severe variant resulting from one HbS gene and one β-thalassemia gene.

Global Data (WHO):

• 400 million carriers of hemoglobin disorder traits. b. 300,000 babies are born each year with severe hemoglobin disorders.

Inheritance of SCD

Genetic Odds:

• Both Parents with SCD: 100% chance of the child inheriting SCD.

• One Parent with SCD, One with Trait: 50% chance of disease; 50% chance of being a carrier.

• One Parent Healthy, One with SCD: 100% chance of being carriers.

Features and Symptoms of SCD

• Sickle Cell Trait: Mostly asymptomatic, no treatment necessary.

Sickle Cell Disease: Sudden and persistent complications:

• Painful Episodes: Acute chest syndrome, avascular necrosis.

• Organ Damage: Blood clots and oxygen deprivation resulting in spleen, kidney, and vein failure.

• Immune Deficiency: Increased vulnerability to infections.

• Other Symptoms: Numbness, extreme pain, inflammation, fever, and swelling.

Global Prevalence of SCD i. Global Data (2000–2021):

• Prevalence grew from 5.46 million to 7.74 million (+41.4%).

• Fatalities rose by 20.8% to 34,000 annually.

• Mortality burden is highest among children under 5 years in sub-Saharan Africa and India.

Geographical Distribution:

• Concentrated in malaria-prone areas: Africa, Middle East, South Asia.

• Significant reductions in Central Europe, Eastern Europe, and Central Asia.

Prevalence in India

Statistics:

• 1.2 million individuals impacted (2021 GBD Study).

• High prevalence within tribal populations.

• Tribal Health Expert Committee identifies SCD in the top 10 health challenges facing tribes.

Demographics:

• Tribal population: 8.6% of India’s total (Census 2011).

• 1 in 86 tribal births is affected by SCD.

Social and Economic Impacts

Health Challenges:

• Regular and lifelong care is essential for SCD management.

• Psychological impact: Depression, absenteeism, productivity decline.

Economic Burden:

• Direct Costs: Testing, treatments, hospital stays, blood transfusions.

• Indirect Costs: Financial pressure on families, job loss, reduced societal productivity.

• Insufficient health infrastructure worsens challenges.

Conclusion

• India’s dedicated strategy to combat SCD demonstrates a commitment to addressing a significant public health issue, particularly among tribal communities. Through strong policy measures, awareness initiatives, and integrated healthcare systems, the NSCAEM aims to ease the burden of SCD while improving the quality of life for those affected individuals.

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Courtesy: Yojana