View Project

1. To assess Infection Profile, Growth, and Development in a Sickle Cell Cohort in Dahanu block of Palghar District

2. To analyze and compare the gut microbiota composition in children with Sickle Cell Disease and Sickle Cell Trait

3. To estimate the prevalence of iron deficiency in children with Sickle Cell Disease and its correlation with disease severity.

Sickle Cell Disease (SCD) is an inherited blood disorder characterized by hemolytic anemia, vaso-occlusive crises (VOC), organ damage, and reduced life expectancy. Recurrent episodes of hypoxia-reperfusion injury in the gut of SCD patients may exacerbate tissue damage, increase intestinal permeability, and lead to bacterial translocation. Although antibiotic prophylaxis is effective in preventing infections due to functional asplenia in SCD, prolonged antibiotic use during the first five years of life can significantly alter gut microbiome diversity and composition. This alteration may result from the combined effects of antibiotics and subclinical bowel ischemia associated with SCD.

The gut microbiome, known to play a critical role in overall health and disease, may significantly influence the outcomes in SCD patients. Additionally, while iron deficiency anemia (IDA) is generally uncommon in SCD due to chronic hemolysis, factors like excessive urinary iron loss and mucosal/submucosal infarctions can impair iron absorption. Environmental influences and poor nutrition further complicate iron metabolism, potentially contributing to iron deficiency, especially during the first decade of life in SCD patients.

This study aims to characterize the gut microbiome in SCD patients and assessing their growth and development with evaluation of early iron deficiency. It will be conducted at the Model Rural Health Research Unit (MRHRU) of ICMR-NIRRCH in Dahanu. The unit is dedicated to addressing local health problems through community-based research.

MRHRU Dahanu has HPLC machine reuired for diagnosis and also Gazelle equipment which can be utilized for testing of Sickle cell disease at field level

This study seeks to improve the health outcomes of children with SCD by addressing key gaps in understanding their microbiota, infection profile, and nutritional deficiencies. The findings will pave the way for targeted strategies to support this vulnerable population.

The study will yield in identification of gut microbiota patterns and diversity in SCD and SCT cohorts and will provide insights into infection trends, including frequency and severity, in children with SCD. It will also give information on prevalence of IDA in young children with SCD. It will create an evidence to develop tailored interventions on infection prevention, nutritional support and Gut microbiota modulation through probiotics or dietary interventions.

• Identification of gut microbiota patterns and diversity in SCD and SCT cohorts

• Provide insights into infection trends, including frequency and severity, in children with SCD.

• Prevalence of IDA in young children with SCD. • Pattern of growth and development

• It will create an evidence to develop tailored interventions on infection prevention, nutritional support and Gut microbiota modulation through probiotics or dietary interventions.

Preparartory Phase- 6months

• Ethical and Administrative approvals

• Community engagement and sensitization activities

• Procurement of kits and training of staff Baseline assessment ( SCD and Trait) and Follow up ( 24 months)

• Iron status-CBC, S. Iron,Ferritin, TIBC

• Gut microbiota analysis

• Clinical and anthropometry

• Clinical, infection tracking -3 monthly

• Document antibiotic/Hydroxyurea treatment Data analysis & Dissemination (6 months)