About 2% of babies born in Ghana have sickle cell disease, among the highest rates in the world. Many more carry the trait without knowing. Of all the serious inherited conditions, it is the one where a cheap blood test changes the most.
Disease and trait
Everyone inherits two copies of the haemoglobin gene, one from each parent. Your genotype is the pair:
| Genotype | What it means |
|---|---|
| AA | Normal haemoglobin |
| AS | Sickle cell trait: a carrier. Usually healthy, but can pass S on |
| AC | Carrier of haemoglobin C |
| SS | Sickle cell disease (sickle cell anaemia) |
| SC | Sickle cell disease, often milder than SS |
When both parents carry - AS and AS, or AS and AC - each pregnancy has roughly a one in four chance of a child with sickle cell disease.
Know your genotype before having children
Get tested. It is one blood test - haemoglobin electrophoresis - done at hospital and private laboratories across Accra, and it is often requested at antenatal care. Many churches ask couples to test before marriage, which is sensible whatever your faith.
A result that both partners carry is not a sentence and not a reason to panic. It is information for a conversation with a doctor or genetic counsellor about the options, including testing during pregnancy.
— The free annual health check
Newborn screening
Ghana began screening newborns for sickle cell in 1993, starting in Greater Accra and Ashanti, and it is still not universal. Screening is offered at major Accra hospitals including Korle Bu, 37 Military Hospital and Ridge.
Ask for it if your baby is born anywhere in Accra, and ask for the result. A baby diagnosed at birth gets antibiotics, vaccines and follow-up before the first crisis; one diagnosed later often first comes in very sick.
Care in Accra
The best-known specialist care is the sickle cell clinic at the Ghana Institute of Clinical Genetics, Korle Bu, and the teaching and regional hospitals have clinics too. Regular care - not just emergency visits - is what keeps people well:
- Folic acid and malaria prevention every day. Malaria triggers crises.
- Vaccinations, including those against pneumonia and meningitis.
- Medicines such as hydroxyurea, which reduce crises for many people; ask the clinic whether yours are covered by NHIS.
- Water, rest and warmth. Dehydration - easy in Accra’s heat - cold, and exhaustion trigger crises.
— Malaria and staying healthy — NHIS
When it is an emergency
Go to a hospital emergency unit at once for: severe pain that does not settle at home, fever, difficulty breathing or chest pain, sudden weakness or difficulty speaking, a painful erection that will not go away, or a child who is pale, floppy or has a swelling belly.
Many people with sickle cell need blood transfusions in their lifetime, which is one reason donors matter.