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As a result of geographical and social barriers, relatively few primary and specialty care health facilities exist in tribal areas, and gaping disparities in health status of tribals, as compared to those in metropolitan areas, are evident. Along with a plethora of infectious diseases including malaria, tuberculosis, polio, and cholera, malnutrition and gastrointestinal disorders are pervasive among tribal populations, and stark deficiencies have been detected in gross amounts of calcium,iron, vitamin A, vitamin C, and animal protein.

            With a large population, burgeoning birth rate, and consanguineous marriage practices, there is a dangerously high prevalence of genetic disorders among tribal populations. Along with amino acid irregularities, Glucose-6-Phosphate Enzyme Deficiency, a fatal and genetically carried deficiency in a blood enzyme, is present in about 15 million tribals, who reside in primarily high-incident malaria zones such as Madhya Pradesh, Maharashtra, Tamil Nadu, Orissa,Gujarat and Assam states. However, it is the presence of sickle cell anemia among tribal populations that has surged to the forefront as a critical public health problem among tribal groups. A congenital haemolytic anemia that results from a defective haemoglobin molecule, the sickle cell disease causes red blood cells to roughen and become sickled. These cells, in turn, result in an impaired circulation, chronic ill health, periodic crises, long-term complications, and premature death. Half of the patients with sickle cell disease die before 20 years of age due to organ failure.

            Epidemiological studies confirmed that sickle cell anemia is rampant in the tribal populace, the prevalence of homozygotes for the sickle gene calculated to be over 20% with an estimated five million individuals predicted as carriers. The sickle gene was first described in tribal groups in South India, and studies illustrate its presence in various parts of India including Tamil Nadu, Madhya Pradesh, Orissa, Gujarat and Kerala. Genetic diseases have traditionally received little attention from urban health services in India, and even less so in tribal areas. As a result, virtually all studies carried out regarding tribal populations and sickle cell disease have strongly recommended that genetic health services be integrated into existing primary health care and medical services to combat the epidemic.

 Due to socio-economic backwardness, population may not have proper attention by the system .Sickle diseases are cluster of diseases.

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Have you worked in tribal areas ? If so please share your experiences regarding the tests performed by you to confirm sickling and what organs were affected ?

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