Factors Affecting the Prognosis and Survival of Individuals with SCA

RESUMO

"The morbidity and mortality of sickle cell anaemia depends on the particular individual and his/her environment. In Uganda and most parts of the sickle cell belt of Sub Sahara Africa where the sickle cell anemia carries a high morbidity and mortality; a large proportion of these patients used to die in early childhood. Today; sizeable proportions of SCA individuals survival into adulthood; and lead productive lives. The oldest known Hbss patient attending Professor Ndugwa's SCA clinic at New Mulago Hospital Kampala is now aged 60 years and also the Co-Chairman of the Uganda Sickle Cell Association is about 57 years of age. Many members of the Association who are SCA; are above 20 years of age. The OBJECTIVES of the present study were the reassess the factors determining the improvement in the prognosis and survival of individuals with sickle cell anaemia. METHOD: A study carried out on the age groups of the SCA patients attending Professor Ndugwa's Clinic at New Mulago Hospital Kampala; and also on SCA patients of the Uganda Sickle Cell Association. Their environment such as Family socio-economic status; Education; protection methods against malaria; Vaccinations received; distance to their health clinic; were all evaluated. CONCLUSION: Observations retrospectively re-affirm that the environment is certainly one of the most important factors. As economic; social and medical conditions improve; the outlook becomes brighter; alghough the severity of SCA is variable. In the absence of any ""cure"" of sickle cell anemia; management is principally to control and improve those environmental factors; such as malaria; which affects the prognosis and survival rate of individuals with Hbss. While our zeal for new and better methods of medical management continues; we must not lose sight of the individual. Each has his or her special problems; anxieties and needs which must not be overlooked."