How Long Can a Person Live With Sickle Cell Disease in Nigeria?

Sickle cell disease (SCD) is a genetic blood condition affecting millions of people globally and prevalent in sub-Saharan countries like Nigeria.

How Long Can a Person Live With Sickle Cell Disease in Nigeria?

Sickle cell disease (SCD) is a genetic blood condition affecting millions of people globally and prevalent in sub-Saharan countries like Nigeria. One of the most challenging questions for families who have sickle cell disease is: How long can a person live with sickle cell disease?

There are no solutions to this. Life expectancy differs from person to person and is influenced by the severity and frequency of complications, type of sickle cell disease, access to medical care, preventive treatment, nutrition and health. Timely diagnosis and proper treatment can help most sickle cell disease patients achieve a good quality of life and lead active productive lives into adulthood. Better access to specialist care and advanced treatment methods are crucial for Nigerian patients in handling complications and enhancing their quality of life.

How long can a person live with sickle cell disease?

Fortunately, there have been many advances in treatment and people with SCD now have a much better chance of living normal lives. However, life expectancy may still be poorer than normal, especially if complications are not detected until later in life or if access to comprehensive care is poor. In some individuals who have sickle cell disease, the condition is not severe and they may live to their 50s, 60s, or older. Some individuals may have serious complications at a younger age. But it is important to note that having sickle cell disease does not always mean a short life. Ongoing medical surveillance, preventive treatment, vaccination and timely treatment of infections and pain can minimize potential severe complications and problems.

What is the connection between Sickle Cell and life expectancy?

In people with sickle cell disease, the red blood cells become stiff and sickle-shaped. These abnormal cells can plug the small blood vessels and cause less oxygen to reach tissues.

Chronic anaemia and repeated blockages can have an impact on other organs over time. Complications include:

  • Severe pain episodes
  • Serious infections
  • Acute chest syndrome
  • Stroke
  • Kidney problems
  • Liver complications
  • Pulmonary hypertension
  • Eye problems
  • Leg ulcers
  • Gallstones
  • Organ damage
  • Pregnancy-related complications

Not all of these complications occur. They can be very different from person to person, in their severity and frequency.

Sickle Cell Disease in Nigerian Population

Sickle cell disease is a significant public health problem in Nigeria and is particularly important to be aware of, screened at birth, counselled and requires continued medical management. Many Nigerian children are diagnosed following symptoms of pain (recurrence), anaemia, infections or poor growth. If diagnosed early, families and doctors can implement preventive measures in advance of serious complications. Children with SCD can benefit from regular review with a haematologist or specialist sickle cell service to help monitor blood counts, growth, organ function and other risk factors.

Factors that can affect life expectancy

There are several factors that can impact the prognosis for the life span of an individual with SCD and their quality of life.

The type of Sickle Cell Disease (SCD)

  • Generally, sickle cell anaemia which is most often associated with HbSS is more severe than other sickle cell genotypes. There may be other clinical courses associated with conditions like HbSC.

A patient's ability to obtain medical attention

  • Regular visits to physicians, diagnostic tests, medications, blood transfusion and emergency care is essential for the prevention and management of complications.

Prevention of Infections

  • Some infections are dangerous to people with SCD. Vaccination, preventive measures and early treatment of suspected infections can minimise risks.

Pain Crises Management

  • If vaso-occlusive pain episodes occur often or are severe it can affect how one lives their life and may be accompanied by complications. With an individualized pain-management plan, patients can be given proper treatment swiftly.

Stroke Prevention

  • Children suffering from sickle cell disease might be at higher risk for stroke. Specialized screening which can include transcranial Doppler ultrasound can help identify children who are at higher risk and appropriate preventive treatment can be recommended.

Treatment Adherence

  • Regular use of prescribed medications and regular doctor visits can help identify issues early and modify treatment as needed.

Is there a cure for Sickle Cell Disease?

In most cases, conventional medications control sickle cell disease, not the genetic cause. One possible cure is a hematopoietic stem cell transplant (also called bone marrow transplant). In this therapy, healthy stem cells from an appropriate donor are used to replace diseased stem cells. But not all patients can be transplanted. Requirements include organ health, availability of tissue, disease severity and a specialist transplant team evaluation. The treatment landscape is also changing with newer therapies such as advanced medicines and gene-based therapies. It is not available and suitable in all countries and for individual patients.

Sickle Cell Treatment in India for Nigerian Patients 

There are specialist centres in Haematology, Paediatric haematology and Bone marrow transplantation in India which provide high level evaluation and treatment for Nigerian patients who need it. Patients are allowed to travel to India when they require their expert opinion, a full evaluation and treatment of complications and/or when they are being evaluated for potentially curative treatments like stem cell transplants. The initial procedure is typically a medical record review, looking at past test results, transfusion history, treatment history and current symptoms. A specialist can then be able to identify treatments that might be suitable. GetWellGo can assist Nigerian patients to plan their medical consultation, hospital choice, treatment cost, travel arrangements, accommodation and other services available for international patients.

What can Nigerian patients do to boost their long term prognosis?

While the life span is not predictable for a person with sickle cell disease, there are some steps that can promote a person's long-term health:

  • Keep up to date with haematology appointments.
  • Follow directions for taking prescribed medicine.
  • Stay adequately hydrated.
  • Follow a healthy and well balanced meal plan.
  • Keep vaccinations up to date.
  • Promptly seek medical care if there is a fever or suspected infection.
  • Follow an individualized pain-management plan.
  • Monitor for symptoms of stroke, breathing difficulties or severe anaemia.
  • Regularly check for kidney, eye and other complications as recommended.
  • Talk with a specialist about hydroxyurea and other disease-modifying treatments if appropriate.
  • Consult an expert to see if stem cell transplantation or other cutting-edge treatments are an option.

It is also important that families are aware of the value of genetic counselling. If couples are carriers of sickle cell trait, they should talk to a health care professional about their reproductive choices.

When is a patient in need of specialist care?

Treatment should not be used to control symptoms as effectively as it should be or if a patient experiences frequent pain crises, complications develop, their treatment is no longer controlling their symptoms or if they are worried about organ damage, a sickle cell specialist should be consulted. Urgent medical attention may be necessary for symptoms such as high fever, difficulty breathing, severe chest pain, sudden weakness, confusion, seizures or symptoms suggestive of a stroke. Often serious complications require early treatment.

Conclusion

The life expectancy can be widely variable depending on the severity of the disease, complications and access to medical treatment and how well the treatment is responded to. SCD is a long-term illness but with advances in diagnosis, prevention, the development of drugs and targeted treatments, the prognosis for many individuals with SCD has improved. Severe patients and/or those that have complications may also be able to avail specialist care and advanced treatment in India for Nigeria. GetWellGo can assist the patients and their families in identifying the hospital or expert needed, arranging a medical assessment and coordinating logistics of travelling to India for treatment.

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