Towards the end of sickle cell disease, hepatitis in Nigeria

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By Dr. Zainab Suleiman

Sickle cell anemia is a serious blood condition that can and will cause a slew of consequences if not treated promptly. Stroke, heart attack, organ failure, and death are all possible complications.

Red blood cells, also known as Erythrocytes twist into a sickle shape in sickle cell disease, an inherited set of illnesses. The cells die early, resulting in a scarcity of healthy red blood cells (sickle cell anemia), as well as obstructing blood flow and causing discomfort (sickle cell crisis).

Pain is a central characteristic of the disease, with patients having inexplicable chronic, pruritus throughout their lives, resulting in many hospitalizations, despite the fact that the majority of episodes are handled at home without the need for medical assistance. Dactylitis, or painful swelling of the hands and feet, can start as early as six months of age and is frequently the symptom that sends the kid to the doctor.

The clinical manifestations range from modest to severe, with some persons having minor disease and others having serious consequences. The prevalence of these clinical symptoms signals the presence of the disease and necessitates laboratory testing to confirm the diagnosis.

Nigeria accounts for about half of the world average of much more than 400,000 newborns born each year with acute haemoglobin abnormalities, with an estimated 200,000 newborn babies per year with sickle cell anemia, the most prevalent type of sickle cell disease.

That implies Nigeria, the country with the greatest prevalence of sickle cell disease in the world.

According to medical experts, these alarming figures have labeled Nigeria as reprobates in the international community.

The Nigerian national government, on the other hand, seems unconcerned about the nation’s status as the world’s epicenter of the epidemic, with past governments making no visible effort to eradicate it.

It is critical to plan considerable actions to educate the public about the dangers of this disease; otherwise, Nigeria would continue to tickle in the shadows for fictitious answers.

On that basis, we ask the federal and state governments to assist persons living with or suffering from hepatitis and sickle cell anaemia. They should help the aforementioned people in the same way that they set up assistance platforms and organizations for people living with AIDS. This will alleviate their problems and the stress of coping with the dreadful diseases.

Unfortunately, Sickle cell patients are treated with contempt at government hospitals, and it is sad that nurses and doctors in some government hospitals don’t grasp what a vaso occlusive crisis is or how to manage it.

Only a few actually understand how to treat and care for these amazing patients, and we much appreciate their efforts. They are, without a doubt, our heroes. However, there is a lot of work to be done, but only a few people are prepared; just a few volunteers are willing to take up the cause of action. This is because the government do not support the few legitimate, functioning, effort and passion-driven foundations, therefore,  sickle cell patients are tossed around like trash, with a series of discriminations hanging on their necks and stigmatization at work. This has led to a number of them losing their jobs and others being unable to find work.

It is regrettable that these folks bear such a heavy weight alone. With their families and loved ones having little to do to help.

Of course, the government can be of great help, and we hereby request that the government come to the aid of this hapless yet amazing people.

Nonetheless, the government’s excellent intentions in the health sector cannot be overlooked, but it is critical that they come to the aid of those suffering from the identified disorders.

This can be accomplished by providing free drugs to treat ailments.

As a result, the financial burden of treating Sickle Cell Disease, SCD, will be dramatically reduced. The monthly provision of free medications will help to reduce their misery.

The treatment of diseases can also be brought under the National Health Insurance Scheme through a suitable insurance scheme.

If a patient also doesn’t have health insurance, he or she will have to pay for medical treatment out of pocket, especially if the surgery is costly, such as hip replacement therapy. In recent study, the cost of a hip replacement varies from one facility to the next and from state to state. In recent time, the average cost of a hip replacement in Nigeria, with implant fees, was over N20 million naira.

How many of these patients are able to afford such a high medical bill?

To remedy the gap in medicaid, the government may provide supplemental insurance through the Healthy Ministry, which would save these folks a huge amount of money and concern.

Blood transfusions are still a common therapeutic option for sickle cell disease (SCD) patients, with the goal of increasing blood oxygen carrying capacity while also reducing the risk of vaso-occlusion consequences.

A sickle patient with HbSS and HbS0 thalassaemia with Hb 9 g/dL is required to get a postoperative basic infusion aiming at a Hb level of 10 g/dL while having low- and moderate-risk surgery. If a patient cannot afford the costly treatment and expense, achieving this is more challenging.

Sickle cell patients, to say the least, are prone to complications, particularly infections or abnormalities of the kidneys. Renal damage and sickle cell nephropathy (SCN) are two examples of underlying processes. Both are linked to hypoxia and ischemia. RBC sickling and congestion in the vasa recta produce ischemia and renal tube damage.

The inner medulla’s hypoxic, acidic, and hyperosmolar environment is known to induce red blood cell (RBC) sickling, resulting in impaired renal medullary blood flow, ischemia, microinfarction, and papillary necrosis.

Hematuria is most usually caused by vascular blockage, which causes RBC extravasation into the collecting system, or papillary necrosis.

In all of these cases, the government should come to the aid of the sufferers, whose lives are in jeopardy due to the destructive spike of these diseases.

Initiatives should be launched to give facilities, expertise, logistical assistance, and maybe cash to those living with Sickle – Cell disease and Hepatitis.

A simple operation for SCD patients would typically cost at least N200.000, medications included. Some of the pills can cost N1,000 or more each tablet, and patients may be obliged to take them for 14-30 days.

Not minding the fact that health is an individual responsibility, it is important to recognize that it is a major public health concern that necessitates the participation of every national psyche, including the individual, community, and state, in order to protect and promote good health,  particularly for people living with Sickle Cell Anaemia and Hepatitis.

Adults and children should be tested for the sickle cell gene in order to raise genotype consciousness and provide prenuptial counseling to carriers of the gene.

Furthermore, Nigeria should capitalize on recent cost reductions in viral hepatitis detection and treatment and enhance investment in disease elimination.

Currently, almost 85 percent of hepatitis patients do not have access to the medications needed to prevent, test for, and treat the condition. As part of its efforts to achieve universal health coverage, I hereby request that the Nigerian government include hepatitis services in benefits and perks.

Nigeria can save lives, particularly those of children and youths, and save costs associated with long-term treatment for cirrhosis and liver cancer caused by chronic hepatitis by rapidly implementing diagnostic tests and medicines for treating hepatitis B and C.

Some countries, such as India and Germany, are already taking aggressive moves and initiatives to provide free drugs to their residents battling sickle cell anemia and hepatitis. As part of its health sector reform goal, India’s government has stated that it will provide free diagnosis and treatment for both hepatitis B and C.

Medicine prices have been reduced, which has made this possible. Hepatitis C treatment costs less than US$40 in India, and hepatitis B treatment costs less than US$30 for a year. Hepatitis C eradication will yield savings in cost of healthcare within three years at current pricing.

In conclusion, the Nigerian government should come to the help of persons suffering from Sickle Cell Anaemia and Hepatitis as soon as possible. They should explore for ways to deliver free drugs to those suffering from these debilitating conditions. The number of persons living with the awful sickness should be known from primary school through Tertiary education. A realistic data set with an actual number of patients is required. The government should address the need and concerns for the elimination of hepatitis and sickle cell anemia in the Nigerian population in the same way it addressed the HIV/AIDS epidemic.

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