Sickle Cell Disease in Central India - Need for Micro Level Planning

Haemoglobinopathies in form of sickle haemoglobin and β -thalassaemia are common in Central India and are important from clinical and disease burden point of view. These disorders are more common in Scheduled Tribes and Scheduled Castes as compared to other endogamous groups of Central India. There is heterogeneity in the distribution of these deleterious genes in the area. In some endogamous groups like Jharia, Mehra in Scheduled Caste group and Pradhan. Panika, Barela, Bhilala in Scheduled Tribe group, sickle haemoglobin has high prevalence and β -thassaemia is very low or absent. In some primitive tribes like Saharia, Hill Korba, Kamar sickle haemoglobin is either absent or with low prevalence but β -thalassaemia is common. The distribution of the ethnic (caste & tribe) groups is also uneven in the various pockets of Madhya pradesh and Chhattisgarh. For examples Jhabua, Dhar, Badwani and Mandla districts of Madhya Pradesh and Bastar, Surguja and Narayanpur districts of Chhattisgarh has high (>60%) proportion of tribes whereas in many districts the proportion of tribal population is less than 20 percent. Both these states need micro level planning to develop the infrastructural facilities, based on the type of abnormal gene and population size of STs and SCs, to diagnose manage and prevent the disease in the area.