Makerere University to lead in fight against sickle cell disease

Scientists from Makerere University have promised to rescue Ugandans with sickle cell by developing groundbreaking research and innovations.

The move comes after an announcement from Mulago Hospital that the sickle cell clinic in Mulago Hospital has registered an increase in the number of sickle cell patients.

Sickle cell disease (SCD) is an inherited blood disorder that causes sickle-shaped red blood cells. These sometimes stick together, blocking blood flow and oxygen from reaching all parts of the body.

Prof Sarah Kiguli, a pediatrician at Mulago Hospital and a lecturer at Makerere University addressing the congregation during a sickle cell Conference at Makerere University Kampala on November 28, 2023. Photos by Godiver Asege

People with sickle cell disease can experience pain (also known as pain crises), anaemia, and infections and in the long-term, damage to almost all organs of the body. SCD also affects aspects of life including academic achievements, employment, marriage and social life.

Speaking during a sickle cell disease stakeholders engagement at Makerere University Vice chancellor, Prof Barnabas Nawangwe said that he has experienced the pain of sickle cell through relatives who are battling with the disease.

“There was a polygamous family in my village, the children of one of the mothers kept on dying at a time when they had completed school. Since no one knew the cause, people started saying that it was witchcraft. Sickle cell affects aspects of life including academic achievements, employment, marriage and social life, so it should be addressed immediately,” Nawangwe narrated.

Prof Nawangwe said that though there are evidence-based strategies that have been used to reduce the effects of SCD like newborn screening, infection prevention, use of hydroxyurea and other disease-modifying agents, the problem remains the low uptake of these strategies in Africa where most people with SCD live.

“To address the high burden of disease due to SCD in Uganda and other countries in Africa, the Makerere University College of Health Sciences will take the initiative to lead the efforts to combat SCD. These efforts include training health workers and other experts in the care of persons with SCD. The college also has ongoing studies and we eagerly await their results,” Prof Nawangwe said.

Statistics from the Ministry of Health show that there are more than 500,000 Ugandans who currently have sickle cell disease. Uganda is one of the top three most affected countries in Africa, where one in every 10 people carries the sickle cell gene.

In her speech, Prof Sarah Kiguli, a pediatrician at Mulago Hospital and a lecturer at Makerere University, emphasized that Secondary School and University students need to be tested for Sickle cell before they get into relationships.

“Our target to curb the disease is to test students so that they get to know their sickle cell status before marriage. Parents are passing the disease on to their children unknowingly because there is less focus on pre-marital testing,” Prof Kiguli said.

How do you get sickle cell disease?

Children with sickle cell disease are born with it. They will have it all their lives and will not outgrow it. It is inherited. If both parents have sickle cell trait, there is a 25% chance that a child will be born with the disease. Sickle cell disease is not contagious.

Symptoms of sickle cell

Dr Annet Nakirulu, a paediatric hematologist at Mulago Hospital said that symptoms or complications are different depending on what type of sickle cell disease the child has. 

According to her, every child is different, some of the complications include, pain, infection, acute chest syndrome, fatigue, jaundice, learning disabilities and stroke.

“Pain is the most common problem; it is caused by sickled cells blocking blood flow to a part of the body. It can come on suddenly and last for days. It is important to learn about triggers for pain including heat, cold, dehydration and infection,” Dr Nakirulu said.