Jharkhand population to be screened for sickle cell anaemia: CCMB

CCMB Director, Dr Vinay K. Nandicoori on Friday announced the initiative which combines the CCMB’s mission towards early diagnosis and making a difference in the lives of SCA families with the TSF’s commitment towards betterment of health of people of Jharkhand.

The pilot project is expected to provide estimates of the SCA burden in the state and aid in designing preventive and management strategies for the disease.

This tripartite MoU between the CSIR-CCMB, the TSF, and the NHM will enable early detection of SCA, raise awareness about the disease, and have a significant impact on the public health scenario of Jharkhand.

The collaborative screening efforts will begin across the Kolhan region of Jharkhand, comprising East Singhbhum, West Singhbhum, and Seraikela-Kharsawan districts through a combined network of the NHM and the TSF.

In addition to training the ANMs, ASHA workers, field assistants and MANSI+ functionaries of the TSF, the CSIR-CCMB will facilitate the establishment of a sickle cell testing hub where large-scale screening of the target population will take place.

Jharkhand, one of the 17 states included in the National Sickle Cell Anemia Elimination Mission (NSCAEM), has a significant burden of SCA and houses a large tribal population. Although SCA screening has taken place in various parts of the state, it has been patchy and, hence, the results may not reflect the true disease burden, the CCMB said.

The CSIR-CCMB will also lend its decades of experience in counselling the carriers and direct the couples for prenatal diagnosis to prevent the disease transmission onto future generations, while the NHM Jharkhand will facilitate integration of this screening project into the existing healthcare framework to provide appropriate management to the patients.

The CSIR conceived the CSIR – Sickle Cell Anemia Mission in 2018, under the leadership of Dr Giriraj Ratan Chandak, a senior scientist and current Sir JC Bose fellow, at the CSIR-CCMB. His scientific team has developed a low-cost, robust, rapid and reliable Dried Blood Spot (DBS) PCR-based molecular test; the first of its kind.

This indigenously developed Make-in-India test has been validated as a screening-cum confirmation test with a sensitivity and specificity of 100 per cent by the Indian Council of Medical Research. This simple test relies on a drop of blood collected on a specially designed paper, followed by a direct PCR without any preprocessing of DBS, and is capable of differentiating between normal, carrier, and diseased individuals at the population level.

According to the senior scientist, the test obviates the need for intravenous blood collection, DNA isolation, QC checking and thus makes the test extremely high throughput. This technique has been used successfully in several areas in the states of Chhattisgarh, Maharashtra, Madhya Pradesh, and Rajasthan, thus establishing the robustness of the test results in diverse settings as well as generating a demographic map of SCA in the country.

SCA is a genetic disorder due to a change (mutation) in the beta globin gene that alters the structure of red blood cells (RBCs), making them sickle-shaped and more prone to destruction (hemolysis), leading to chronic anemia and vaso-occlusive crisis. It occurs due to a mutation and follows an autosomal recessive inheritance pattern, such that affected children are born when carrier and/or affected individuals procreate with each other.

The Centre launched the NSCAEM in July 2023 to eliminate the disease by 2047 through universal screening of approximately 7 crore people in the 0-40 years age group in high-prevalence areas, especially tribal areas, and counselling through collaborative efforts of central ministries.