JCRC launches new machine to ease sickle cell treatment

HEALTH|SICKLE CELL ANAEMIA|JCRC

The Joint Clinical Research Centre (JCRC) has launched a high-tech machine to ease treatment for sickle cell anaemia.

The treatment option also known as red blood cell exchange (RBC) is big relief for those suffering from sickle cell anaemia, a condition which comes with periodic episodes of pain, also known as pain crises.

The procedure, also known as apheresis is only performed at JCRC in Uganda. "The treatment enables patients with sickle cells to live a better life," Dr Daniel Muyanja, the director of clinical services at JCRC, said.

RBC is a non-surgical therapy that removes abnormal red blood cells and replaces them with healthy ones derived from blood donors. Dr Muyanja said the therapy is mainly used to treat complications of sickle cell disease. "The best treatment for the sickle cell patient is the RBC because you are removing 70% of sickle cells," Muyanja said.

In sickle cell disease, red blood cells are abnormal in shape and do not fl ow well through small blood vessels, which can prevent oxygen from reaching the tissues. At least 19 patients have benefi ted from the new treatment so far.

Muyanja said the cost for the procedure is between sh2m and sh3m per session. However, JCRC is trying to get partners to subsidise the cost and make treatment affordable for more Ugandans.

Currently, bone marrow transplantation (BMT) is the only known cure for sickle cell disease. It involves replacing the abnormal stem cells residing in bone marrow with healthy cells from an eligible brother or sister. BMT is not available in Uganda and most patients travel abroad for the procedure. The estimated cost of BMT in India is about $15,000 to $18,000 for autologous bone marrow transplant and $21,000 to $24,000 for allogeneic bone marrow transplant.

An autologous stem cell transplant uses healthy blood stem cells from your own body to replace diseased or damaged bone marrow.

Dr Francis Ssali said apheresis is very effective, adding that in the UK children with sickle cell disease are put on routine red blood cell exchange and they live a normal life like other children.

Dr Gerald Mutungi, the head of noncommunicable disease prevention and control programme at health ministry, requested researchers at JCRC to document the evidence and effectiveness of the apheresis compared to other treatment modalities. He said if the evidence is convincing then the ministry will have procedures done in regional referral hospitals.

Beneficiary speaks out

Evelyn Mwesigwa, whose son has lived with sickle cell disease for the last 13 years, said because of the pain he has to endure, she opted for apheresis. "What worried me was his chest. He got complications and could not breathe, the pain was too much,'' she said.

She said her son will continue with the treatment and management to ensure that he takes much longer without experiencing any pain crisis.

Muyanja said when the sickle cell disease patient gets the treatment he or she can go up to six months without getting painful attacks. Experts said acute chest syndrome is the major killer of all patients with sickle cell disease. "With acute chest syndrome, the child breathes badly.  They will need oxygen and when you do X-rays it looks abnormal as if they have pneumonia,'' Muyanja said.

Muyanja added that some children may need more exchange transfusion than others, say three times a year while others need it once. Sickle cell prevalence at national level stands at 13.3% and the disease burden at 0.73%.