SOLUTION: TU Sickle Cell Disease how The Disorder Affects African Americans Essay

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Running Head: SICKLE CELL DISEASE
1
Sickle Cell Disease- How the Disorder Disproportionately Affects African Americans than Any
Other Ethnicity
Tedderika Redding
Independent Study SOWK
September 19, 2020
SICKLE CELL DISEASE
I.
2
II.
Introduction
Sickle Cell Disease.
A. What causes sickle cell disease?
1. The genes responsible for sickle cell disease.
B. Signs and symptoms of sickle cell disease.
III.
Prevalence of sickle cell disease in the United States as a whole.
A. Prevalence among Caucasians.
B. Prevalence among Hispanics.
C. Prevalence among African Americans.
D. Prevalence among Africans.
IV.
Why sickle cell disease disproportionately affects African Americans.
A. The sickle cell gene is more prevalent among Africans and African Americans.
B. Healthcare inequality means less African Americans have access to treatment.
V.
Conclusion
● Topic: Sickle Cell Disease among African Americans in the US.
● Question: How and why does sickle cell disease disproportionately affect African
Americans compared to other racial groups in the US?
● Purpose: The main purpose of this research is to investigate the disproportional
prevalence of sickle cell disease among African Americans as opposed to other racial
groups in the US. The cause of sickle cell disease is a genetic mutation of the sickle cell
gene, which is more likely to occur in people of African descent than other racial groups
or African Americans. It is less prevalent among African Americans with a higher genetic
admixture from non-Africans.
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SICKLE CELL DISEASE
Abstract
Sickle Cell Anemia (SCA) consists of blood cell disorders that a person took after the parent
caused a defective gene (the sickle cell gene). The disease causes an individual’s hemoglobin to
form stiff rods within the individual’s red blood cells. Apart from altering the shape of red blood
cells (from the conventional disc-shaped to a crescent, sickle shape), the disease hampers the
effective transport of oxygen throughout the individual’s body. The condition is genetically
inherited from parents. A defective sickle cell gene causes it from mutations. People born with
the disease have two sickle cell genes, each given by each parent. Individuals with sickle cell
trait (only one gene) carry on their lives without any problems with the condition. The disease
affects around 70,000 to 100,000 Americans today. The number of people is stratified among
races and ethnic groups- it occurs in African Americans compared to other racial groups.
Individuals with more significant indigenous African genetic characteristics are more likely to
have sickle cell trait or the disease itself. African Americans with a genetic makeup that resemble
West African tribes like Yoruba and Mende people have higher chances of suffering from the
disease than African Americans with more significant genetic admixture from Caucasian
ancestors. Sickle Cell Anemia happens in about one out of every three sixty-five African
Americans born compared to 16,300 Hispanic-American births and is even higher among
Caucasians. It is estimated that around 1 in every 13 African American babies are born with the
illness. This higher risk, coupled with healthcare inequality, means more African Americans are
affected by the disease and cannot get the diagnosis and treatment level they may require.
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SICKLE CELL DISEASE
I. Introduction
Sickle cell disease is one of the community diseases, and it has raised a significant
concern because many people are suffering from it. Its occurrences vary from one state to
another, and it affects different races as well as different ethnicities. People with SCD have an
abnormality with their hemoglobin, called hemoglobin S in their red blood cells. Mutations are a
gene in the hemoglobin that causes sickle cell Anemia. It is generally a genetic disorder in the
U.S, and Americans are more prevalent than other populations. According to the researcher,
about 500 American babies are born with sickle cell anemia, and one out of twelve is African
American people who have the gene of the disease. About 100,000 Americans are considered to
be having the disorder, and each year, another 1000 babies are found with it. Approximately
3million Americans of American populations carry the gene for SCD. Patients with the disease
are found that the red blood cells don’t stay alive for long, thus they have low red blood cells in
number. The patient is asymptomatic until about four to five months period. The medium age of
death is around 42 years for men and 48 years for women.
The government performed a screening project to measure sickle cell disease prevalence
in school-age children from October 2007 to December 2017. The screening data estimated that
the prevalence of SCD was relatively high for the school-age children in various geographical
areas and social classes. The sickle cell patients and carriers among them were evaluated to be
27,101 and 71,483, respectively. These estimates can develop a policy and better coordinate and
care for the patients with this disease.
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SICKLE CELL DISEASE
II. Sickle cell disease
A. What causes sickle cell disease?
The genes responsible for sickle cell disease.
A mutating gene causes sickle cell disease in the hemoglobin beta gene situated in one of
the chromosomes. People suffering from sickle cell diseases have abnormal hemoglobin, which
sticks to one another to form rod-like structures. This rod-like structure causes red blood cells to
become stiff, rigid, and sticky, assuming a sickle shape. When they become sickle, it is hard for
them to pass through capillaries, causing blockage or even organ damage. These cells have a
short life span, and when they die, the number of red blood cells decreases, causing anemia.
(Mandal et al., 2015) explain that individuals born with sickle cell disease develop in adulthood
and that SCD is genetic in recessive shape. The authors outlined individuals that inherit altered
gene are said to be the carrier.
B. Signs and symptoms of sickle cell disease.
There are several symptoms of sickle cell disease. They include anemia; this happens
because most abnormal hemoglobin dies, and, in the process, few red blood cells remain, thus
reducing the amount of iron in the body, therefore causing anemia. Also, patients experience
many episodes of pain when there is a blockage in the capillaries, and the blood does not flow
properly. The swelling of hands and feet might be seen at times when a blockage occurs on the
hands or feet. Patients experience frequent infections because sickle cells damage the spleen
leaving the patient exposed to so many infections. At times the patient might experience vision
problems because veins supplying blood to the eye can be plugged at times by sickle celldamaging the retina. Patients with SCD need proper care involving taking vitamin folic acid to
generate new cells that may increase hemoglobin. Azacytidine makes the hemoglobin F, which
SICKLE CELL DISEASE
6
makes the oxygen flow more, drinking a lot of water every time, avoiding hot or cold climates,
and getting plenty rest are the general guidelines that help to keep the sickle cell individual
healthy.
III. Prevalence of sickle cell disease in the United States as a whole
A. Prevalence among African Americans
The researchers have found that seven to nine percent of African American populations
have been seen as benign carriers are sickle cell trait. Although it’s unusual, many effects of
sickle cell traits have been presented that have set low tension of oxygen and higher demands of
oxygen. (Derebail et al., 2018) provided that the renal medulla’s low oxygen content gives a
setting for intravascular illness. The trait is involved with less and distorted vessels of vasa recta
that possibly transform into more prevalent impaired urinary concentration. The renal
microvascular barrier happens with HbAS that reports the most common asymptomatic
hematuria found from different researchers.
According to (Mandal et al., 2015), it’s reported that 70 percent of them in the U.S are
sickle cell anemia and 8% to 9% of African Americans in the U.S are the carriers of the sickle
cell traits. The condition is dangerous though it can be managed with appropriate care. Newborn
screening has been a successful way of screening the population for sickle cell diseases. The
babies that carry oxygen seem to suffocate with deoxygenated hemoglobin that destroys their
cells, leading to blood clotting. The author outlined that excitement, pains on the chest, and
breathing difficulties are the symptoms of sickle cell diseases. If the disorder is not noticed after
both the sample of its blood can be used in a test known as hemoglobin electrophoreses, it helps
get if the person has the disease or is the carrier.
SICKLE CELL DISEASE
7
According to the researcher, it’s found that 4000 to 5000, pregnant women are found to
have a risk of SCD every year. The author outlined that new redbone marrows are always
produced to replace the old one after 120 days, while the sickle-shaped cell lasts for 10 to 20
days. Researchers found that Sickle cell diseases happen among one out of every 365 African
American birth and approximately 100,000 in general. SCD occurs about one out of every
16,300 Hispanic-American given birth, and around one in thirteen Black kids born are sickle cell
trait.
B. Prevalence among Africans
According to (Baker et al., 2015), he explains that Africa’s associated high childhood
mortality rate is about 50% to 90%. There is nowhere they can depend on up-to-date
information. The research found that valuable data about childhood in African were about 40
years ago. They hypothesized that sickle cell disease among the African population lacked access
to treatments and preventive measures. The fact that children under five years were dead due to
SCD was essential to draw the policy that would support and resources to ensure measures are
taken to mitigate the burden of mortality among Africans.
An increase in mortality because of SCD among the African children under five years has
been eradicated using different interventions that include newborn screening and mitigation of
infection through penicillin and polyvalent pneumococcal vaccinations outlined by the authors.
Researchers have found that creating awareness is one of the effective means of reducing Sickle
cell diseases among Africans. It’s also possible to decrease mortality among African children
that suffer from SCD by good follow-up care. Still, one big issue is the evaluation of costeffectiveness to newborn screening.
SICKLE CELL DISEASE
8
C. Prevalence among Hispanic
Researchers have found that about 1 out of 16,300 Hispanic-Americans are given birth
with sickle cell disease. Sickle cell traits being inherited, and it’s a disorder that changes a
million Americans that are eight toward ten percent are African Americans. It affects Hispanics,
South Asians, and Caucasians. (Solovieff et al., 2011) provide that in the United States, seven
out of a thousand births are Hispanics with sickle cell traits, and the Blacks with sickle cell traits
are about 73 out of 1000. The authors further established that chronic kidney disorders are
common with SCA patients, reported the same in Hispanic populations.
D. Prevalence of Caucasians.
According to (Mandal et al., 2015), African Americans have a generic admixture with
Europeans of about 20% to 30%. The authors suggested that HbS genes are more prevalent in
African Americans than the Caucasian population. An approximate of 250,000 single nucleotide
polymorphisms is used to tell the admixture level and genetic ancestry of African Americans
with sickle cell diseases compared with patients’ genetics for the three subgroups of Blacks
without the Caucasian European population. African Americans have lower Caucasian admixture
than African American without the disease.
IV. Why sickle cell disease disproportionately affects African Americans.
A. Sickle cell disease disproportionally affects Africans and African Americans.
Sickle cell disease affects any ethnicity since it is a disorder of red blood cells that is
inherited. According to the researchers, approximately 1 out of 365 are African Americans,
which shows that they are commonly affected compared to other races. Since malaria is
prevalent in Africa hence makes sickle cell diseases common since it gives protection against
malaria. According to (Soloviev et al., 2011), these areas in Africa are selected to be HbS
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SICKLE CELL DISEASE
carriers since the trait has some resistance to malaria. The authors’ central assumptions are that
their red blood cells have abnormal hemoglobin that tries to sickle when the malaria parasite
attacks them. The African Americana with SCD has low chances of being admixed since they
must inherit two duplicates of sickles mutation, which is more common in the African
population.
B. Healthcare inequality among African Americans
According to (Baker et al., 2015), they explained different kinds of disparities in funding
and treating Sickle cell disease patients compared to other diseases. One main aspect that struck
was the state refusing to expand the Medicaid and distribution plan to the African American
population with sickle cell. Disparities among politics, racism, and economic difference reflected
and were viewed among different ethical groups. The authors outlined that Hispanics could
receive twice as no pain on medication during an emergency visit than the African Americans
who were undertreated on their pains. This showed racial biases since pain for sickle cell crises
were undertreated among different races or ethnicity.
Conclusion
According to the (CDC, 2016), the exact number of the individual having Sickle cell
disease is unknown in the U.S. The projects were responsible for knowing about the people
having SCD were supported by the CDC to understand how this disease affects health. Soloviev
el.at (2011) concluded that African Americans are disproportionally affected due to the area they
live that is prompt to malaria parasites. And these areas are found to be HbS carriers due to
malaria resistance. The authors outlined that the purpose of the research is to investigate the
disproportionate prevalence of SCD among African Americans in response to other ethnicities in
SICKLE CELL DISEASE
the U.S. The authors concluded that of sickle cell diseases, that genetic mutation gene mostly
happens in the African American population same found in other studies.
10
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SICKLE CELL DISEASE
References
Baker, C., Grant, A. M., George, M. G., Grosse, S. D., &Adamkiewicz, T. V. (2015).
Contribution of Sickle Cell Disease to the Pediatric Stroke Burden Among Hospital
Discharges of the African-Americans-United States, 1997-2012. Pediatric Blood &
Cancer, 62(12), 2076–2081. https://doi.org/10.1002/pbc.25655
CDC. (2016, August 31). Data & Statistics on Sickle Cell Disease. Centers for Disease Control
and Prevention. https://www.cdc.gov/ncbddd/sicklecell/data.html
Derebail, V. K., Nachman, P. H., Key, N. S., Ansede, H., Falk, R. J., &Kshirsagar, A. V. (2018).
High Prevalence of Sickle Cell Trait in African Americans with ESRD. Journal of the
American Society of Nephrology : JASN, 21(3), 413–417.
https://doi.org/10.1681/ASN.2009070705
Mandal, S., Mishra, S., & Mandal, P. K. (2015). Sickle Cell Disease with Special Emphasis on
African Americans: An Overview. Journal of Bioprocessing & Biotechniques, 5(10).
https://doi.org/10.4172/2155-9821.1000e138
Solovieff, N., Hartley, S. W., Baldwin, C. T., Klings, E. S., Gladwin, M. T., Taylor, J. G., Kato,
G. J., Farrer, L. A., Steinberg, M. H., &Sebastiani, P. (2011). Ancestry of African
Americans with sickle cell disease. Blood Cells, Molecules, and Diseases, 47(1), 41–45.
https://doi.org/10.1016/j.bcmd.2011.04.002

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