BURDEN OF SICKLE CELL DISEASES AMONG TRIBES OF INDIA- A BURNING PROBLEM

Abstract

The tribal communities constitute a major part of India. Sickle cell disease is a genetically transmitted hemoglobinopathy. Sickle hemoglobin was first detected by Lehman and Cutbush in 1952 among the tribals from Nilgiris. During the last 54 years, several groups of investigators conducted hospital based on epidemiological surveys in various ethnic groups. Based on these surveys, prevalence of sickle gene is found to be 0-18% in north eastern India, 0-33.5% in western India,22.5-44.4% in central India and 1-40% in southern India and the gene frequency of Hb-S varies between 0.031- 0.41. Wide variability in the prevalence of Hb-S trait is observed in population groups within small geographical areas. It causes high degree of morbidity and mortality. There is paucity of data with respect to its prevalence, Due to geographical and social barriers, relatively few primary and specialty care health facilities exist in tribal areas, and gaping disparities in health status of tribals, as compared to those in metropolitan areas, are evident. With a large population, burgeoning birth rate, and consanguineous marriage practices, there is a dangerously high prevalence of genetic disorders among tribal populations. Epidemiological studies confirmed that sickle cell anemia is rampant in the tribal populace, the prevalence of homozygotes for the sickle gene calculated to be over 20% with an estimated five million individuals predicted as carriers. It is recommended that genetic health services be integrated into existing primary health care and medical services to combat the epidemic.