Comprehensive integrated care for patients with sickle cell disease in a remote aboriginal tribal population in southern India

Abstract

High quality comprehensive care for SCD can be delivered for a low income, aboriginal population in India through a community driven network of care. This model can serve as a template for healthcare delivery for SCD in low-income communities.

Attrition from Care and Clinical Outcomes in a Cohort of Sickle Cell Disease Patients in a Tribal Area of Western India

“…The higher LTFU rates were due to improvement in the LTFU tracking system with an IT-based background. Higher rates (36%) of LTFU in SCD patients were reported from Gudalur, Tamil Nadu [14]. In our study, LTFU was more likely among those without any formal education.…”

Clinical events in a large prospective cohort of children with sickle cell disease in Nagpur, India: evidence against a milder clinical phenotype in India

“…Together, the SC (1,108 castes, 16.6% of the population), ST (744 tribes, 8.6% of the population), and OBC (5,013 castes, 41% of the population) are a diverse group of endogamous communities that constitute a substantial proportion of India's population . Extensive studies of the population distribution of the β s gene in India indicate that it is most prevalent in the ST population, but is also prevalent in many SC and to a lesser extent, OBC populations . Community screening studies for SCD have previously described the distribution of β s in the SC, ST, and OBC populations in Nagpur …”

“…32 Extensive studies of the population distribution of the s gene in India indicate that it is most prevalent in the ST population, but is also prevalent in many SC and to a lesser extent, OBC populations. 5,8,[11][12][13][14][15][16]20,21,33,34 Community screening studies for SCD have previously described the distribution of s in the SC, ST, and OBC populations in Nagpur. 31,34,35…”

A task shifting mental health program for an impoverished rural Indian community

“…ASHWINI implements healthcare in three tiers (Nimgaonkar et al, 2014). The first tier consists of village health workers (VHWs) who provide basic healthcare in Adivasi villages, including antenatal health services, immunization and growth monitoring for children, first aid and continuity of care for patients on prolonged medication.…”

“…We applied and evaluated the latter option in Tamil Nadu state, South India, consistent with the Indian District Mental Health Program and the National Mental Health Policy. The area covered by our program is home to about 25,000 indigenous citizens known as 'Adivasis', comprising 10% of the region's population (Nimgaonkar et al, 2014). They have endured extreme hardship, including forced dispossession of their land, bonded labor and extreme poverty (http://www.adivasi.net/ accord.php).…”