AIIMS Bhopal Study Flags Hidden Organ Damage in Sickle Cell Kids

India carries one of the heaviest sickle cell disease burdens globally. The country has the highest hemoglobin S allele frequencies globally and ranks third in births of babies with HbSS, the most severe form of the disease, known for the severe organ damage.

Roughly one in every 86 births in India is affected by sickle cell disease. Sickle cell disease is not merely anemia; it stunts growth and quietly destroys the patient’s body. New research just shows that sickle cell disease not just stunts growth, but can also lead to severe organ damage.

India's National Mission to Screen and Eliminate SCD

Recognising the scale of the crisis, the Government of India launched the National Sickle Cell Anaemia Elimination Mission (NSCAEM) in July 2023. The mission focuses on screening over 70 million people under the age of 40. The initial focus was on 17 high-prevalence states, including Madhya Pradesh, Chhattisgarh, Jharkhand, Odisha, Gujarat, and Maharashtra. The major vision behind this mission is to eliminate sickle cell disease as a public health problem in India before 2047.

This mission is backed up by three pillars: health promotion through awareness and pre-marital genetic counseling, universal screening for early detection, and continuous management across primary and tertiary healthcare. Village Health Sanitation and Nutrition Committee meetings, Anganwadis, self-help groups, and Eklavya Model Residential Schools were all mobilized for the mission.

By September 2024, more than 42 million individuals had been screened, with 163,765 sickle cell disease cases identified.

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New Research Reveals What Routine Tests Are Missing

A recent study by AIIMS Bhopal, published in the International Pediatric Nephrology journal and led by Dr. Harshitha S. under the guidance of Dr. Girish Chandra Bhatt, has uncovered a range of serious hidden complications in pediatric sickle cell disease patients that routine medical examinations consistently failed to detect.

Using a 24-hour ambulatory blood pressure monitoring, researchers identified hidden blood pressure abnormalities in multiple patients, including elevated blood pressure during sleep, a risk factor that standard clinic visits would never flag.

The study also revealed the prevalence of obstructive sleep apnea among the children examined a condition that significantly raises the risk of blood vessel and heart damage over time. Strikingly, nearly 71 percent of children showed signs of early cardiovascular or vascular injury despite presenting normal blood pressure. Early kidney complications, including proteinuria, an indicator of kidney damage, were also detected. Advanced assessments using cystatin C revealed reduced kidney function in patients whose conventional tests had normal results.

Dr Girish Chandra Bhatt, Professor of Pediatric Nephrology, Department of Pediatrics, AIIMS Bhopal, said, “These findings show that children with sickle cell disease require regular screening beyond routine blood tests. Early detection of hidden heart, kidney, and sleep-related complications can help improve treatment and long-term outcomes.”