A Physician Encounter With Sickle Cell Disorder
As a carrier of the sickle cell
trait (AS), I found out about the implication of Sickle Cell Disease in my
early childhood and understood that if I married someone with the trait or the
disease I have a high chance of having offspring(s) who will either be carriers
This I learnt through my close
interaction with healthcare professionals and personal first-hand experiences with
families and friends suffering from the disease. Along the journey of my
medical career I have also managed and lost patients to the disease which
imposes huge socioeconomic burden on the patient, family and the society at
Despite huge global advancement
in scientific and technological know-how focused on prevention, eradication,
management and the cure of SCD, it is sad to see Africa still lagging behind
the US and Europe where the total disease burden is less than 8% but childhood
survival has increased to 95%.
Morbidity and mortality remains
high in Africa due to lack of cohesive implementation strategy and are
compounded by various barriers to access of basic healthcare services in Africa
including; shortage of doctors, poor healthcare infrastructures, long travel
distance to healthcare facilities and importantly, the high cost of treatment.
Barriers to access can
substantially be addressed through telemedicine- use of modern day technology
like mobile phones to provide clinical care from a distance. It has the
potential to revolutionise access especially in Africa.
Africa is one of the fastest
growing continent when it comes to mobile technology adoption with more than
400 million mobile subscribers, 40% smart phone penetration and 3G/4G network
that rivals Europe and the US.
Nigeria alone has at least
150,000 new born with Sickle Cell Disease annually. Research has shown the
tremendous benefit of Telemedicine in improving access to care for patients
The data from Medical College
of Georgia (MCG) in Augusta which provides consultative services and
comprehensive medical care to more than 1200 sickle cell patients showed an
increase in the demand for clinical services in this patient population and
increased access to care for rural patients in underserved areas.
with sickle cell disease (SCD) in Africa who live at long distances from the
healthcare centers have difficulty with clinic visit compliance, whereas the morbidity of a
painful crises has been known to continue after patients have been discharge from hospital.
Also, the provisions
of neonatal screening and surveillance are still low and there is still paucity
of specialized centers for the long-term management of those living with SCD.
telemedicine we can achieve greater patient monitoring, compliance, reduce
acute crises and manage chronic SCD better. It will also improve prevention and
management of Non-communicable diseases such as Hypertension, Heart Diseases,
Diabetes, Obesity and Cancer- which are on the rise in Africa as a result of globalization and economic changes.
Telemedicine proffers a highly
scalable, cost and time effective solution for prevention, screening,
surveillance, management of acute crises and chronic diseases, monitoring and
prompt management of complications and providing psychological and educational
support to those whose functional capacity and academic performance has been
hampered by the disease.
pioneering integrated telemedicine mobile
app aims to bridge these gaps between patients and providers along the whole
spectrum of care through integrated one-stop solution that addresses most of
Advances in newborn
screening and papediatric management of sickle cell disease have resulted in patients
living well into adulthood. For adults, preventive care and medication
monitoring are crucial for optimal health maintenance.
So, patients with Sickle Cell Disease in Nigeria
and other African countries will benefit greatly from telemedicine from
management of acute crises, to nutritional counselling, psychological support
for patient and family, pre-natal and ante-natal support, individualized care
plan to help improve compliance, health education around various myths and generally
supporting their well-being and educational development for those whose educational
performance might be affected by their medical condition.
About the Writer
Dr. Funmi Adewara, MBBS (Ib), MPhil (Cambridge), is a Physician, CEO/Founder of Mobihealth International, United Kingdom.