Sickle Cell Anaemia – UPSC Notes
What is Sickle Cell Anaemia?
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A genetic blood disorder caused by a mutation in the HBB gene that produces abnormal haemoglobin called Haemoglobin S.
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Causes red blood cells to become rigid, sticky, and sickle-shaped, which block blood flow.
Cause
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Autosomal recessive genetic condition.
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A mutation in the gene for beta-globin (part of haemoglobin).
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A person must inherit two defective genes (SS) to have the disease.
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If one gene is defective (AS), the person is a carrier (sickle cell trait).
Symptoms
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Anemia
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Fatigue
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Painful episodes (vaso-occlusive crisis)
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Swelling in hands and feet
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Frequent infections
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Delayed growth and puberty
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Vision problems
Diagnosis
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Hemoglobin electrophoresis
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Blood smear
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Newborn screening programs
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Prenatal diagnosis (via amniocentesis or chorionic villus sampling)
Treatment
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No universal cure (except bone marrow/stem cell transplant in some cases)
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Management includes:
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Pain relief
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Hydroxyurea (reduces sickling episodes)
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Blood transfusions
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Vaccination and antibiotics to prevent infections
Sickle Cell in India
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Mostly found among Scheduled Tribes (STs), some Scheduled Castes (SCs), and Other Backward Classes (OBCs)
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High prevalence in states like:
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Madhya Pradesh, Chhattisgarh, Odisha, Maharashtra, Gujarat, Jharkhand, and Telangana
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A serious public health challenge in tribal regions
Government Initiatives
1. National Sickle Cell Anaemia Elimination Mission (2023)
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Launched by PM Modi on 1 July 2023 from Shahdol, MP
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Aim: Eliminate sickle cell disease by 2047
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Components:
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Awareness generation
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Universal screening of 7 crore people (0–40 years) in tribal areas
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Counselling and genetic testing
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Digital registry for tracking
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2. Rashtriya Bal Swasthya Karyakram (RBSK)
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Screens children for diseases including sickle cell anemia
3. Ayushman Bharat – Health and Wellness Centres
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Deliver primary healthcare services including screening for NCDs and sickle cell anemia
Ethical & Social Issues (GS Paper IV & II)
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Genetic screening and counselling raise ethical dilemmas (e.g., stigmatisation, marriage choices)
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Equity in healthcare access for tribal populations
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Social discrimination faced by patients
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Need for culturally sensitive public health programs
Way Forward
To achieve the 2047 goal, India must:
- Scale up newborn and prenatal screening to prevent genetic transmission.
- Strengthen healthcare infrastructure in tribal areas with trained staff and consistent drug supply.
- Launch targeted awareness campaigns to reduce stigma, modelled on successful polio and HIV initiatives.
- Invest in affordable gene therapies and local research to make treatments accessible.
- Foster intersectoral collaboration involving central/state governments, NGOs, and community leaders.
This multi-pronged approach, combining technology, policy, and community engagement, is crucial to tackling SCD effectively in India.
