Why no disaggregated data on tribal populations, asks House panel
Context:
The Union government was criticized for not having data that was broken down by the country’s tribal people’s health status in a report submitted to the House by a parliamentary committee on women’s empowerment. The study also recommended significant data gathering in this area.
What did the report by the parliamentary committee on Women’s Empowerment portray?
- A report on women’s empowerment was delivered in the House by a parliamentary committee.
- The Union government has come under fire for its lack of disaggregated data on the nation’s tribal inhabitants’ state of health.
- The intention was to provide the Tribal Affairs Ministry more flexibility in how to allocate funds for tribal welfare in the areas of health, education, nutrition, skill development, and subsistence.
- The report of the committee presented a worrying picture of the state of tribal women’s health.
- Leprosy and sickle cell anaemia are two conditions that are more common in indigenous populations.
- The committee received a written note from the Health Ministry.
- It brought attention to the rise of genetic disorders in tribal communities, such as sickle cell disease and G-6 PD deficiency.
What is G6PD deficiency?
- Genetic Basis:
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- Mutations in the G6PD gene, which is found on the X chromosome, lead to G6PD deficiency, a genetic condition.
- Males are more likely to be affected than females since it has an X-linked recessive pattern. If two mutant copies of the gene are inherited, females may be carriers of the gene or, in rare instances, show symptoms.
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- Enzyme Function:
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- The pentose phosphate pathway, which is essential for generating cellular energy and preserving the proper ratio of antioxidants and oxidants in cells, contains the enzyme G6PD.
- G6PD reduces nicotinamide adenine dinucleotide phosphate (NADP+) to NADPH while catalyzing the conversion of glucose-6-phosphate to 6-phosphoglucono-lactone. For cells to be protected from oxidative damage, NADPH is necessary.
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- Role in Red Blood Cells:
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- Red blood cells (erythrocytes) have a high oxygen content and few repair mechanisms, making them particularly susceptible to oxidative stress.
- Red blood cells are kept supplied with NADPH by G6PD, which helps to combat oxidative stress and shields the cells from damage.
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- Hemolytic episodes can be brought on by several things, including:
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- Foods: Due to their oxidative propensity, fava beans (favism) might cause hemolysis when consumed.
- Medicines: Several medications, including certain antibiotics, sulfa medications, and antimalarials, can cause hemolysis.
- Increased oxidative stress and hemolytic events can both be brought on by infections.
- Chemicals: Naphthalene, which is a chemical compound present in mothballs, can cause hemolysis when exposed to it.
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- Mild to severe symptoms of G6PD deficiency include:
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- When hemolytic episodes occur, mild cases could go unrecognized or just slightly worsen anaemia.
- Due to the disintegration of red blood cells, severe cases can cause considerable anaemia, jaundice, weariness, and black urine.
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- Management:
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- Despite the lack of treatment, care focuses on preventing hemolytic episodes:
- Avoiding triggers: Patients are recommended to stay away from certain substances, drugs, and foods that are known to cause oxidative stress.
- Use of drugs with caution: To administer safe medications, doctors must be aware of a patient’s G6PD status.
- Monitoring: It’s crucial to follow up frequently and keep an eye on your haemoglobin levels.
What is sickle cell anaemia?
- Genetic Mutation:
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- Sickle cell anaemia is brought on by a mutation in the HBB gene, which codes for the production of haemoglobin, the oxygen-carrying protein in red blood cells.
- Hemoglobin S (HbS), an aberrant haemoglobin, is produced as a result of the mutation.
- An individual needs two copies of the defective gene (one from each parent) to have the condition because the mutation is inherited in an autosomal recessive manner.
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- Abnormal Red Blood Cells:
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- Hemoglobin S tends to produce insoluble fibres when it releases oxygen, giving abnormal red blood cells a sickle shape.
- Sickle cells are less flexible, sticky, and stretchy than typical red blood cells, which makes them more difficult to flow through blood arteries.
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- Anemia and Fatigue:
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- Sickle cells have a shorter life span than regular red blood cells, which causes chronic anaemia and fatigue.
- Anemia causes the blood’s ability to carry oxygen to be diminished, which causes weakness, exhaustion, and pallor.
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- Organ Damage and Complications:
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- Blockages that reduce blood flow can harm several organs.
- The spleen can become initially enlarged and then gradually destroyed, resulting in functional asplenia (loss of normal spleen function), which is caused by the filtering and eliminating of old red blood cells.
- Complications from organ damage might include strokes, renal damage, and pulmonary hypertension (high blood pressure in the lungs).
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- Diagnosis:
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- Blood tests, such as hemoglobin electrophoresis, which looks for unusual hemoglobin types, are used to confirm the diagnosis.
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- Treatment:
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- Management is a form of treatment that tries to reduce symptoms, avoid complications, and enhance quality of life.
- It’s important to manage discomfort during crises, which frequently involves using analgesics (painkillers) and staying hydrated.
- Transfusions of blood can boost oxygen supply and temporarily increase the amount of healthy red blood cells.
- A drug called hydroxyurea can increase fetal haemoglobin synthesis, which lessens the frequency and severity of crises.
- Potentially curative procedures like bone marrow or stem cell transplants are constrained by the dangers involved and the lack of available donors.
What are the possible ways in handling these challenges faced by the tribes?
- Limited Healthcare Access: Access to medical facilities, diagnostic procedures, and specialized treatment for managing these illnesses and their complications may be restricted in tribal communities.
- Genetic counselling and education: To ensure well-informed decisions and appropriate management, it is essential to raise awareness of these disorders, offer genetic counselling, and inform people about the dangers and preventive actions.
- Community support: Support networks and community-based interventions can be very helpful in enhancing health outcomes and fostering early detection given the possible frequency of these illnesses within tribal groups.
- Research and Data: To develop efficient healthcare plans and allocate resources, precise data on the prevalence and effects of various illnesses within tribal groups must be collected.
In conclusion, the research underscored the need for more thorough data collecting and policy planning for their welfare and emphasized the absence of information on tribal health conditions. It also expressed concerns about illnesses and anaemia among tribal women. The committee advocated for action to address these health issues in tribal populations and suggested strengthening the Tribal Affairs Ministry.
