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 or sufferers.

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 large.

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 with SCD.

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.

Patients 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.

Through 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.

Mobihealth’s 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 these barriers.

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.