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Sickle cell disease (SCD) is a sickness that affects the red blood cells in an individual’s bloodstream. Sickle cell is a genetic condition that causes normally round and flexible blood cells to become stiff and sickle-shaped.
This stops blood cells, and the oxygen they carry, from moving around the body, causing anaemia and unpredictable pain and swelling when blood vessels get blocked. Without a diagnosis, people with sickle cell disease are at risk of complications such as:
- acute chest syndrome
- bone damage
Over time, they can experience widespread organ damage, including to the liver, kidney, lungs, heart and spleen . For SCD to manifest itself, an individual must inherit two sickle cell genes; people who inherit one sickle cell gene and one normal gene have the sickle cell trait but not the disease .
SCD is prevalent across the African region, as more than 70% of children with the disease are born in sub-Saharan Africa. In Kenya, circa 4.5% of children are born with SCD, and 18% with the sickle cell trait. The disease is concentrated in the western and coastal regions of the country where malaria outbreaks are more frequent. SCD has contributed significantly to under age 5 mortality rates, primarily due to late diagnosis (or lack thereof), educational gaps among health providers and improper treatment.
In an effort to increase the availability of reliable diagnostic tools for SCD, Ilara Health has launched a pilot with a partner clinic based in Awasi, a town in Kisumu County where 17-21 out of 100 children are born with the sickle cell trait. We have deployed Hemex Health’s Gazelle diagnostic device, a miniaturized version of the widespread test known as cellulose acetate electrophoresis. The tool utilizes single-use cartridges and displays results in less than 8 minutes; it requires minimal training which Ilara Health provides to the lab technician during installation.
Image credit: HemexHealth
This device has the potential to increase accessibility and affordability of SCD diagnostics for thousands of individuals in the region. The clinician, Dr Argwings Miruka, notes that SCD screenings are traditionally available only in Kisumu city, where test prices range between 500 KES and 2,500 KES, prohibiting patients in Awasi from getting tested.
Dr Miruka sees the Gazelle as an opportunity to improve access to SDC screenings by:
- Offering the test to all Awasi residents in a close-by location
- Improving the price affordability
- Increase awareness of the disease across his patient base
Comprehensive information campaigns and care programmes on SCD are required to create more public awareness while minimizing the risks of stigmatization of people with the condition. Countries across Africa, including Ghana and Nigeria, have set up different types of SCD screening programmes. Some target newborn babies in the hospital, as early detection of the condition will enable adequate disease management throughout the patient’s life; others target young adults to equip them with the necessary diagnosis to make informed choices about their future. Kenya has recently announced plans to establish its own comprehensive SCD Center in Kisumu which will offer a daily sickle cell clinic and provide therapeutic apheresis to remove defective red blood cells.
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Author: Gabrielle De Haan Montes, Impact Fellow