PSYCHOLOGICAL IMPACT OF LIVING WITH SICKLE CELL ANAEMIA

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INTRODUCTION

1.0        Introduction

The problem of sickle cell anaemia is in different faces. In this work we are looking at the social aspect of the sickle cell anaemia or the psychological impact of people living with sickle cell anaemia. People do not see them as normal, majority of the people see people with sickle cell anaemia  as a  working corpse that can die at any time.

1.1       Background of study

The condition of having sickle cell disease will be defined as occurring in one or the other of the two following states: (1) sickle cell anemia-a severe, uncorrectable, and often fatal anemia with many clinical manifestations, and (2) sickle cell trait–a relatively benign condition with symptomatology occurring only under extraordinary circumstances.

Hemoglobin functions as the oxygen carrying substance of the blood, and is responsible for the pigmentation of the erythrocytes or red blood cells. The condition of sickle cell anemia results from the presence of an abnormal hemoglobin, known as Hb-S, in the erythrocytes. The presence of this hemoglobin is hypothesized to have been an asset in protecting· its bearer from the effects of malaria in those countries where the occurrence of malaria is common. In 1964, A. C. Allison (Levitan and Montagu 1971), proposed, that the· heterpgygote AS was less susceptible· than the normal homozygotes to Falciparum malaria, an often fatal· malaria constantly reinfecting its victims with severe and prolonged disease.

However, for that segment of the population carry in the abnormal hemoglobins, but residing in no malaria environments, the advantage of hemoglobin S disappears.

In the United States, sickle cell anemia is found predominantly Wintrobe (1967), the “frequency of occurrence of sickle cell trait is 8.5 per cent of the black population. Approximately one out of four hundred blacks (National Sickle Cell Prevention Act, 1971) experiences the anemia itself. The incidence of the disease in other races is quite rare, and when it does occur in members of other races, it is usually experienced by persons of Greek, Italian, East Indian, South American and Middle Eastern origins.

Clinical Manifestations

Sickle cell anemia has been referred to as “the great mimicry” due to the ‘multiphasic manifestations and complexities of its symptoms. Consequently, the risk of incorrect early diagnosis is high. (Lin-Fu 1965)

In infants, symptomatology, particularly in the first few months of life, is bizarre and non-specific’. Major complaints ‘usually include colic, failu~e to thrive, jaundice, nausea and vomiting, recurrent fever, and swelling in hands and feet.

In older children, periodic occurrences of acute episodes with various manifestations, facilitate recognition of sickle cell anemia. These episodes, known 8S “crises”

(Lin-Fu, ibid.), are brought about when the erythrocytes or red blood cells begin to sickle. Sickling is the term used to describe the change that occurs within the cells under conditions of reduced oxygenation. The cells elongate and twist into distorted shapes that prohibit free flowing movement of the blood. It is proposed that “logjams” of these rigid cells form, resulting in impeded circulation in the smaller vessels, thus inhibiting the flow of oxygen to the affected part of the body. This blood flow obstruction causes tissue death, which produces acute, incapacitating pain in any part of the body, fever, and many other non-specific symptoms. This symptom complex comprises the sickle cell crisis.”

Other manifestations include necrosis, which might occur resulting in chronic leg ulcers; however, this is less common among those children afflicted wit~ sickle cell anemia than for adults. Incipient blindness from retinal detachment might also result from sickling and reduced. Oxygenation in the cells of the eyes. The result is an overall retarded growth and development, and increased susceptibility to infections and pneumonia are further manifestations of the anemia. The childhood victim of this illness is usually characterized by a. barrel-shaped chest, enlarged protruding abdomen; and thin extremities.

Sickle Cell Trait

The trait form of· sickle cell disease has no clinical manifestations except under extraordinary circumstances, during which the individual might experience a crisis similar to that of ‘the anemia victims. Thus, symptomatology in sickle cell trait can be virtually obliterated by avoiding those circumstances which would precipitate a crisis conditional Sickle cell trait individuals may be incapacitated by (1) conditions of extreme hypoxia, such as flying in an unpressurized aircraft or with underwater swimming, (2) during anesthesia when anoxia has inadvertently occurred, (3)occurrence of occasional severe pneumonia, .and (4) extr.eme physical exercise.

 Etiology

Sickle cell disease, in both its forms, is a genetically acquired condition. (Song, ibid) Inherited as an autosomal recessive ,pattern (Fraser 1966), sickle cell anemia is the homogygo~s state of the abnormal hemoglobin S gene. The mating of two persons with the sickle cell trait would imply a 25 per cent probability that each offspring will inherit two abnormal genes (Hb-s) ,8 25 per cent probability that the offspring will inherit two normal genes, and a 50 per cent probability that the offspring will inherit one normal gene and one abnormal gene. In other words, based on statistical calculation using ‘a Mendelian model, (Fraser,ibid, Stern and Sherwood 1966) a family consisting of four offsprihg will produce one offspring having sickle cell anemia, one offspring that is free of any sickle cell gene,and two offspring having one normal, and one abnormal gene

The union between one person having sickle cell anemia (the homogygous state of the abnormal hemoglobin S gene) and another person free of a sickle cell gene, will produce’offspring having one normal and one abnormal gene Sickle cell trait is the heterozygous state of the abnormal hemoglobin S gene. The union between a person with the sickle cell trait and a person free of the sickle ‘eelI  gene implies a 50 per cent probability that the offspring will have the sickle cell trait, and. a 50 per cent probability that the offspring will be free of the sickle cell gene .

Inheritance Patterns of Sickle Cell Disease

Treatment

During crisis situations, -treatment is largely supportive and symptomatic. Oxygen administration and the use of analgesics and sedatives seem to be somewhat effective in reducing the painful symptoms of the acute sickling periods.

Management and care must extend beyond medical treatment.Optimal nutrition, satisfactory dental and hygienic care, and avoidance of “exposure to infection and crisis precipitating factors are essential in the care of the individual during quiescent periods.

The use “of urea has received considerable recent interest “in the treatment of sickle cell anemia, and feasibility studies are currently underway to determine the extent that urea is effective as a prophylactiC measure in the prevention of crisis.- Unfortunately, no treatment has been universally demonstrated or accepted as an effective combatant of sickle cell disease.

1.2       Statement of the problem

Sickle cell anaemia has been with man for a long time, a lot myth surrounds its occurrence and management. In recent times science and technology had laid bear on those traditional beliefs. It is now known to all and sundry that it is a disease that is inherited from once parents. Resulting in a sickle shape of the red blood cells. This cause a reduction in the amount of oxygen absorbed into the body by the red blood cells. Aside the disease the traumatic or psychological trauma it causes is another side of the problem entirely. The way to manage this trauma and re-unite the patient to the fold of his or her peer is the focus of this study.

1.3       Objective of the study

The aim of this research among others would be;

  1. To find out if there is psychological assault in Babcock University.
  2. To know the cause of psychological assault on people suffering from Sickle cell Anaemia Babcock University.
  3. To find out possible ways to reduce or eradicate the psychological assault on people suffering from Sickle Cell Anaemia in Babcock University.

1.4       Research questions

This research would be driven by the following questions:

1. Is there any psychological assault on people living with sickle cell anaemia in Babcock University?

2. What are the causes of psychological assault on people living with sickle cell anaemia in Babcock University?

3. Is there any way that people living with sickle cell in Babcock university can be help from psychological assault?

PSYCHOLOGICAL IMPACT OF LIVING WITH SICKLE CELL ANAEMIA