Beyond the screening: The need for health systems intervention for prevention and management of sickle cell disease among tribal population of India
Beyond the screening: The need for health systems intervention for prevention and management of sickle cell disease among tribal population of India
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DOI：
10.1002/hpm.3081
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发表时间：
2020-09-30
影响因子：
2.7
通讯作者：
Babu, Bontha V.
中科院分区：
文献类型：
--
作者：
Geethakumari, Konathala;Kusuma, Yadlapalli S.;Babu, Bontha V.
在全球范围内，镰状细胞病（SCD）是主要的公共卫生问题之一。在印度，它在部落社区更为普遍。部落社区在社会经济上处于不利地位，占印度人口的8.6%。这些社区的卫生保健和寻求保健的情况非常差。虽然有有效的干预措施来管理慢性阻塞性肺病，但这些措施并没有惠及这些人，也没有制定全面的方案。本分析的目的是作为一个案例，证明印度安得拉邦和特伦加纳两个邦部落的慢性阻塞性肺病负担，并强调该国需要进行公共卫生干预和加强卫生系统，以预防和管理慢性阻塞性肺病。在这些州的部落人口中，十分之一的人携带Hb S基因。每年有相当数量的儿童出生时患有这种疾病。大多数情况下，这项研究仅限于筛查。因此，应制订一项及早发现的方案和适当的转诊制度。应加强初级卫生保健系统，通过良好的疾病管理做法和适当的社区动员活动筛查和管理慢性阻塞性肺病患者。该方案应与传统治疗师和社区领袖合作。应该鼓励人们寻求治疗；以及预防咨询。这项研究保证在干预期间采取以人为本的方法，以解决害怕被污名化的可能威胁。因此，将循证干预措施转变为方案和实践可以改善SCD患者的生活，特别是部落人口。
Globally, sickle cell disease (SCD) is one of the major public health problems. In India, it is more prevalent in tribal communities. Tribal communities are socio-economically disadvantaged and constitute 8.6% of India's population. The health and health care seeking of these communities is very poor. Though efficacious interventions are available to manage SCD, they are not reaching these people and no comprehensive programme is in place. The objective of this analysis is to demonstrate the burden of SCD among the tribes in two Indian states of Andhra Pradesh and Telangana, as a case and to highlight the need for public health intervention and health systems strengthening in the country to prevent and manage SCD. One in 10 persons of tribal population of these states carries Hb S gene. A substantial number of children are born every year with the condition. Mostly, the research is limited to screening. Hence, a programme with early detection and an appropriate referral system should be developed. The primary health care system should be strengthened to screen and manage SCD persons with good disease management practices and appropriate community mobilisation activities. The programme should partner with traditional healers and community leaders. People should be encouraged to seek treatment; and counselling for prevention. The study warrants human-centric approaches during the interventions to address the possible threat of fear of being stigmatised. Thus, the transition of evidence-based interventions into the programme and practice can improve the lives of people with SCD, particularly the tribal population.