Thalassemia and hemoglobinopathy prevalence in a community-based sample in Sylhet, Bangladesh

Abstract

Background Inherited blood disorders affect 7% of the population worldwide, with higher prevalences in countries in the “thalassemia belt,” which includes Bangladesh. Clinical management options for severely affected individuals are expensive; thus, targeted government policies are needed to support prevention and treatment programs. In Bangladesh, there is a lack of data, in particular community-based estimates, to determine population prevalence. This study aims to estimate the prevalence of a wide range of hemoglobinopathies and their associations with anemia in a community-based sample of women and young children in rural Sylhet, Bangladesh. Methods Capillary blood samples from 900 reproductive-aged women and 395 children (aged 6–37 months) participating in the Food and Agricultural Approaches to Reducing Malnutrition (FAARM) trial in two sub-districts of Habiganj, Sylhet Division, Bangladesh were analyzed for alpha thalassemia, beta thalassemia, and other hemoglobinopathies. We examined the association of each inherited blood disorder with hemoglobin concentration and anemia using linear and logistic regression. Results We identified at least one inherited blood disorder in 11% of women and 10% of children. Alpha thalassemia was most prevalent, identified in 7% of women and 5% of children, followed by beta thalassemia and hemoglobin E in 2–3%. We also identified cases of hemoglobin S and hemoglobin D in this population. Having any of the identified inherited blood disorders was associated with lower hemoglobin values among non-pregnant women, largely driven by alpha and beta thalassemia. Pregnant women with beta thalassemia were also more likely to have lower hemoglobin concentrations. Among children, we found weak evidence for a relationship between hemoglobinopathy and lower hemoglobin concentrations. Conclusions We found a high prevalence of alpha thalassemia among both women and children in rural Sylhet, Bangladesh–higher than all other identified hemoglobinopathies combined. Community-based estimates of alpha thalassemia prevalence in Bangladesh are scarce, yet our findings suggest that alpha thalassemia may comprise the majority of inherited blood disorders in some regions of the country. We recommend that future research on inherited blood disorders in Bangladesh include estimates of alpha thalassemia in their reporting for public health awareness and to facilitate couples counseling.

Heart Failure Attributable to Hemoglobinopathies and Hemolytic Anemia: A Three-Decade Cross-Sectional Assessment of the Global Burden

“…(22) Our ndings indicate that in resource-poor regions, particularly those within sub-Saharan Africa, hemoglobinopathies and hemolytic anemias present with the highest absolute case numbers and prevalence rates, potentially exacerbated by a concentration of HB variants in speci c populations. (23) A study involving 900 reproductive-age women and 395 children from anemia-endemic nations found that at least one genetic blood disorder was prevalent in 11% of women and 10% of children, (24) with malnutrition and food scarcity likely compounding this burden. High SDI areas, re ecting higher income, education, and fertility control,( 14) generally provide better access to healthcare services including prenatal care, genetic counseling, and disease management.…”

Consanguineous marriages, premarital screening, and genetic testing: a survey among Saudi university students

“…Consanguinity can increase the chance of genetic diseases in offspring, especially if the population is ethnically similar (5). Blood disorders like sickle cell anemia and thalassemia are common in countries like the Kingdom of Saudi Arabia (KSA), the population of the Mediterranean basin, India, Pakistan, Bangladesh, Southeast Asia & Pacific Islands (6). Mental illnesses like depression and schizophrenia may also be more prevalent in families that practice CM (7).…”

Problems Faced by Parents of Thalassemia Children Aftermath of the Covid-19 in South Punjab

“…In both alpha and beta thalassemia, the severity of thalassemia symptoms escalates as more globin chains become affected. In severe cases, iron chelation therapy and transfusion dependence become necessary for survival (Amanda et al, 2023). Thalassemia presents a significant healthcare challenge globally, with diverse forms and varying levels of severity.…”