Looking at sickle cell anaemia

Dr Douglas Street, Contributor

Jamaica is a country where people are mostly of African descent, and as a result, we have to grapple with conditions that are common in blacks. Sickle cell anaemia is one such condition. Most of us know someone who has this condition as a significant portion of our population suffers from it. Let's look at some facts about it.

Sickle cell anaemia is an inherited genetic condition where the red blood cells form a crescent shape since they are under stress. The width of the smallest blood vessels in the body is actually smaller than that of the red blood cell, so they literally have to squeeze through.

In sickle cell anaemia, the red blood cells form a crescent shape that is not as flexible, and, therefore, they can no longer manoeuvre through these tiny blood vessels and they get stuck there. As the red blood cells are like oxygen delivery trucks, the body tissues suffer from a lack of oxygen, resulting in severe pain.

the gene

About 10 per cent of our population carries the sickle cell gene, and 0.3 per cent of Jamaicans have sickle cell anaemia. To have the condition, one must get two sickle cell genes, one from each parent. If both parents have one sickle gene each (sickle cell trait), then each child they have will have a 25 per cent chance of having sickle cell anaemia.

Persons with sickle cell anaemia may have various problems. They can get painful crises, where they get severe pain in the joints, abdomen, and chest. They also have anaemia as the sickle cells are broken down more quickly.

They may also have episodes where the anaemia gets suddenly worse when the red cells may collect in the liver, or when infections shut down the red-cell production. They are even prone to infection as part of their immune system (the spleen) is destroyed by the sickle cells.

Pregnancy is a particularly dangerous prospect for a person with sickle cell anaemia as complications are frequent and can be life-threatening. They also get gallstones frequently. Other problems include strokes, vision problems, ankle ulcers, and priapism (an erection of the penis that lasts dangerously long).

A person with sickle cell anaemia should keep warm, drink lots of fluids, treat infections quickly, eat lots of bright-coloured fruits and vegetables (especially those with folic acid), limit alcohol intake, exercise cautiously, keep stress to a minimum, and have regular doctor's visits. They should also seek medical attention early when complications arise.

Dr Douglas Street is a general practitioner and has private practices at Trinity Medical Centre, Trinity Mall; 3 Barnett Street, Montego Bay; and Omega Medical Centre, Plaza de Negril, Negril. Send feedback to drdougstreet@yahoo.com.