Sickle cell disease (SCD) is a genetic blood disorder affecting red blood cells, with high morbidity and mortality rates.  Sickle haemoglobin (HbS) is a structural variant of normal adult haemoglobin (HbA).

SCD includes a series of pathological genotypes resulting from the inheritance of HbS. It is estimated that 240,000 children are born with SCD annually in sub-Saharan Africa (Makani et al., 2011). The most common subtype of SCD worldwide is homozygous SCD, characterized by the presence of two copies of the β-globin S (βS) mutation that codes for sickle cell hemoglobin (Hb S). Homozygous SCD is variably referred to as sickle cell anemia, Hb SS, SS, SS disease, or sickle cell disease-SS.

Sickle cell disease has contributed substantially to mortality in children younger than 5 years in sub-Saharan Africa. SCD patients in the developed world account for only 10% of the world’s SCD patient population (Aygun & Odame, 2012). In 2008, Aliyu et al. (2008)  that there are between 20 and 25 million people worldwide living with SCD, of which  75–85% of children born with SCD are born in Africa, where mortality rates for those under age 5 range from 50% to 80% (Aygun & Odame, 2012; Makani et al., 2011. In Uganda, approximately 20,000 to 30,000 babies per year are thought to be born with sickle cell disease (Aygun & Odame, 2012).

The highest prevalence of sickle-cell trait (SCT) in Africa occurs between the latitudes of 15° North and 20° south, where the prevalence ranges between 10% and 40% of the population (Agasa et al., 2010). In 2010, Rawezula reported results of a study of records of over 2000 newborns at a hospital in Tanzania (Rwezaula, 2010). Findings indicated that 18.2% of the neonates had abnormal hemoglobin levels and that the incidence of abnormal hemoglobin levels differed based on the geographical regions of the newborns’ parents.    

The distribution of the βS allele has recently been mapped globally using detailed geo-referenced data and displays a close association with the historical distribution of Plasmodium falciparum malarial endemicity.                                                                                                                                                  

Within Africa, the frequency of βS, and accordingly SS, is highest in low-altitude equatorial regions. The second subtype of SCD common in Africa is compound heterozygosity for βS and βC (SC). The βC allele is found almost exclusively among people of West African ancestry, being most common among those in Burkina Faso and northern Ghana.   

Symptoms

Signs and symptoms of sickle cell anemia, which vary from person to person and change over time, include:

  • Anemia. Sickle cells break apart easily and die, leaving you without enough red blood cells. Red blood cells usually live for about 120 days before they need to be replaced. But sickle cells usually die in 10 to 20 days, leaving a shortage of red blood cells (anemia).

Without enough red blood cells, your body can’t get the oxygen it needs to feel energized, causing fatigue.

  • Episodes of pain. Periodic episodes of pain, called crises, are a major symptom of sickle cell anemia. Pain develops when sickle-shaped red blood cells block blood flow through tiny blood vessels to your chest, abdomen and joints. Pain can also occur in your bones.

The pain varies in intensity and can last for a few hours to a few weeks. Some people have only a few pain episodes. Others have a dozen or more crises a year. If a crisis is severe enough, you might need to be hospitalized.

Some adolescents and adults with sickle cell anemia also have chronic pain, which can result from bone and joint damage, ulcers and other causes.

  • Painful swelling of hands and feet. The swelling is caused by sickle-shaped red blood cells blocking blood flow to the hands and feet.
  • Frequent infections. Sickle cells can damage an organ that fights infection (spleen), leaving you more vulnerable to infections. Doctors commonly give infants and children with sickle cell anemia vaccinations and antibiotics to prevent potentially life-threatening infections, such as pneumonia.
  • Delayed growth. Red blood cells provide your body with the oxygen and nutrients you need for growth. A shortage of healthy red blood cells can slow growth in infants and children and delay puberty in teenagers.
  • Vision problems. Tiny blood vessels that supply your eyes may become plugged with sickle cells. This can damage the retina — the portion of the eye that processes visual images, leading to vision problems.

Development of Home Remedy for Sickle cell Anaemia

The use of traditional herbal remedies and medications in the management of SCD is a common practice in poor resourced countries such as Uganda, where access to care is limited and the population is predominantly rural. Communities in Uganda have long relied on using medicinal natural plants with potential anti-sickling properties that have been used since centuries in different regions of the country with beneficial effects.  Some of these remedies have immune boosting properties and ability to relieve the symptoms of SCD crises

In line with this, Dr Lutwama George on personal resources has been making public awareness about this condition with an aim of Uganda to be a sickle cell free nation. He has appeared on different Uganda local fm stations (Central Broadcasting Services, Radio one, Kingdom fm, Radio star, Radio two, radio mama and has gone ahead to write an article in the Uganda Local daily Bukedde).

In 2011 Dr Lutwama George joined hands with several researchers at the Natural chemotherapeutic Research institute particularly Dr Ogwanga Patrick, Ministry of Health Uganda. They researched on the root extract of  herb called Zanthoxyllum chylebeum (Fagara) and consequently a home remedy has been formulated by Crest Natural health Center based on homeopathic practice. This remedy has been found to possess anti sickling and anti-malarial properties.

In 2014, Crest Natural Health center together with the sickle cell information center headed by Achan Jacinta, started to assist ten children with this condition and has been doing observation studies using this remedy. Worthy noting is that the parents of these children were not charged for the service. The good news is that the children are doing very well on this remedy. The occurance of painful crisis is drastically reduced and the children can now concentrate on their studies.

Before the children are started on this programme, a blood test Hb electrophesis is done first and in doing so we know the percentage of sickling red blood cells as well as adult and fetal hemoglobin (hemoglobin F). They are given this drug twice daily while monitoring their health. After duration of three months, another blood test is taken (Hb Electrophesis) and a decrease of sickling red blood cell is reduced as well as increase in the adult hemoglobin is registered. The health condition of these children has improved thus a decrease of getting painful crisis is reduced and we see these children attending school un interrupted.

Photos of some of the children with SCD treated at crest natural health center in conjunction with sickle cell information center