COMMUNITY CONTROL PROGRAME CENTRE
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1 COMMUNITY CONTROL PROGRAME CENTRE!! Dr. S. L. Kate (M.Sc., Ph.D.)!!! Emeritus Medical Scientist Maharashtra Arogya Mandal Hadapsar, Pune, M.S. Former Professor & HOD of Biochemistry, Deputy Director Tribal Health Research Project Dept. of Pediatrics, B.J.Medical College, Pune , M.S, India -: Office :- HOD- Sickle Cell Dept Sane Guruji Arogya Kendra, Malwadi, Hadapsar, Pune
2 Red Blood Cells
3
4
5 Sickle : Origin of the name The name is derived from the shape of red blood cell which is like a sickle, the tool use for grass cutting
6 About Sickle Cell Disorder What goes wrong??? Normal Shaped RBC Sickle Shaped RBC Transformation of RBC from Round Shape to Sickle cell shape is known as sickling process These sickled RBC get early destructed, leading to anaemia known as sickle cell anaemia Factor responsible for this process is Sickle Cell Haemoglobin Molecule
7 Common Symptom PAIN Basic Sickle cell hemoglobin genetic defect not only give rise to anaemia but affect all organs
8 Last 65 years studies emerge out following observations : It affect all part of the body but does not affect every patient in the same way. Differ widely from individual to individual Differ in both extent of complications & severity
9 Clinical Findings Common : Anaemia, Jaundice(yellowish ting in eye), Joint pain Splenomegaly Hepatomegaly Gallbladder stones Avascular necrosis of femoral head Acute chest syndrome Hand Foot syndrome( in children only) Stork Crisis vaso-occlusive crisis Very painful Majority 3-4 times year Sometime medical emergency May succumb to death Lea ulceration (Not recorded) Priapism (Not recorded) Retinal changes (Not Found)
10 CRISIS
11 : Diagnosis : Haemoglobin Haemogram Smear studies Solubility test Electrophoresis Family studies HPLC studies (Doubtful cases)
12 Laboratory diagnostic criteria - Blood test Solubility test Electrophoresis pattern Sickle Cell status Negative A+A Normal Positive A+S Carrier
13 Cellulose Acetate Membrane Electrophoresis (at alkaline ph 8.6)
14 ID Cards After screening the Identity card given to person! White Normal Yellow Carrier Red sufferer! At the back Marriage counseling chart
15
16 Map of Maharashtra
17 Prevalence for sickle cell disorder (carrier) amongst scheduled Tribe population in Satpuda Hilly ranges:- State of Maharashtra.! North! Maharashtra!! No. Tribes:- Bhill and Pawara Dist. Prevalence % 1. Otakar Gadchiroli Pardhan Gadchiroli, Chandrapur, Pawara Nandurbar, Jalgaon,Dhule Madia Gadchiroli Bhill Nandurbar Halbi Gadchiroli Gonds Gadchiroli, Bhandara, Gondia,Chandrapur Korku Amravati Kolam Yeotmal Warli Thane Katkari Pune, Raigad Kokana Nashik Andha Nanded Mahadeo Koli Pune, Nashik Thakar Pune, Raigad Paradhi Solapur 0
18
19 Dist Total Tribal Population of North Maharashtra (Khandesh) Major Tribal Groups Two (Bhill & Pawra) Total Population Tribal Population (Fig. in Lakhs) Tribal % Nandurbar % Dhule % Jalgaon % Total Population Genetic survey for sickle cell gene --- Total population screened in 3 districts Normal individuals (A+A) Carrier individuals (A+S) Sufferer individuals (S+S) 2,05, (78.99 %) (19.80 %) 2483 (1.21 %)
20 Community Control Center Sickle Cell Dawakhana Roshmal Bk. Tal. Dhadgaon, Dist. Nandurbar, Maharashtra, India. Centre established 1998 Maharashtra Arogya Mandal, Pune Location: between 3 rd & 4 th ranges of Satpuda 21.5 N, 74 E
21 Community Control Satellite Centre Dr. Dada Gujar Sickle Cell Centre Aakulkhede Bk. Tal. Chopda Dist. Jalgaon, Maharashtra, India Centre established 2016 Maharashtra Arogya Mandal, Pune Location: N, E
22 Activities of centre Diagnosis (blood testing) Clinical Examination & ayu. treatment Counselling (patients & parents) Population genetic survey Family studies Improvement in QOL Marriage counselling Genetic counselling Training (other NGO) Research
23 Patient s DIARY Full Name Address Age Sex Caste Tribes / Sub Types Contact information Registration Number along with Date. Information about Medicine Doses & Clinical findings.
24 SICKLE CELL PATIENTS IDENTIFIED FROM LAST 12 YEARS (NANDURBAR, DHULE, JALGAON, MADHYA PRADESH AND GUJARATH) We have registered >3261* homozygous patients from this area
25 Family of 8 sickle cell anaemia patients
26 OBSERVATIONS GENERAL CONDITION OF PATIENTS IMPROVED! IMPROVEMENT IN ANAEMIA STATUS! CRISIS SEVERITY AND DURATION DECREASES! NO ALLERGIC REACTION
27 ! ALLOPATHIC DRUGS Hydroxyurea to reduce severity of symptoms - but 1. Not affordable 2. Life long treatment 3. Repeated hematological investigations needed MODERN TREATMENT Disease is not curable by medicine or surgery B.M.T. Stem Cell Therapy Gene therapy (available but costly)
28 Prevention strategy Aim - Avoid birth of S.C.D. child (Mainly) Pre-marriage counselling Prenatal Diagnosis Pre-implantation facilities (Mainly) Family Planning Chorionic Villus Biopsy Amniotic fluid
29 Counselling - Information, Education and Communication Approach
30 Community Control Programme Centre is really dedicated centre Land donated by tribal youth (Manoj Pawra) All administrative & Laboratory diagnosis work (local tribal youth) Located at Geographical difficult Satpudha Hill Ranges, according to need of tribals Diagnosis, treatment and counselling free of charge All volunteers work sincerely without any expectations Patients, parents and people are Happy with our friendly treatment Hence it is Dedicated Centre
31 ACCURATE DIAGNOSIS PROPER MEDICAL CARE GOOD NUTRITIONAL SUPPORT GOOD FAMILY SUPPORT! CAN ALLEVIATE SYMPTOMS Prolong life help Sickle cell patient to be active & happy
32 Ayurvedic perspective Ayurvedic treatment Prior to conception
33 Some memory of our 100 th CAMP
34 Team of our 100 th CAMP
35 Patient s at Sickle Cell Dawakhana
36 Our felt sorrowful As we lost our supporter
37 _/\_ WE OWE TO _/\_ DR. DADA GUJAR &! DR. GRAHAM SARGENT
38 THANK YOU... Let us unite together and combat this genetic disorder! Sickle Cell Team Sickle Cell Department Maharashtra Arogya Mandal Hadapsar, Pune-28
39 THANK YOU... Let us unite together and combat this genetic disorder! Sickle Cell Team Sickle Cell Department Maharashtra Arogya Mandal Hadapsar, Pune-28
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