β-Thalassemia: the Lebanese experience

Abstract

Beta-thalassemia is a hereditary anemia that is quite prevalent in Lebanon. Most patients with beta-Thalassemia are treated and followed up mostly at a multidisciplinary center, located in the suburban area of Beirut: the Chronic Care Center (CCC), operational since 1994. We will review the experience with beta-Thalassemia accumulated through this institution. Four hundred and twenty five patients, aged 2 to 68 years are followed up at the CCC. Sixty four percent have thalassemia major (TM) while 36% have thalassemia intermedia (TI). Lebanese patients with TM receive periodic packed red cell transfusions to maintain a pre-transfusional hemoglobin level of 10 gm/dl at all times and desferrioxamine is the standard iron chelator in use. Since 1994, 12 patients with TM have died from complications of their disease, with heart failure being responsible for the majority of deaths. The incidence of cardiac, endocrinologic, and infectious complications will be reviewed. Finally, both current and prospective preventive measures will be discussed, specifically educational campaigns and premarital screening. The effects of prevention are starting to show as the number of newly diagnosed disease is diminishing.

Carrier Screening for β Thalassemia in Pregnant Indian Women: Experience at a Single Center in Madhya Pradesh

“…Because of higher rates of IUGR and oligohydramnios, ultrasound surveillance of fetal weight should be done for early detection of IUGR [10,11] Countries like Pakistan, Iran, Saudi Arabia, and Lebanon which initially practiced only premarital screening to disallow marriage where both partners were carriers have now reinterpreted religion to include prenatal diagnosis and abortion till a particular gestation [12].…”

The Prevention of Thalassemia

“…When Cyprus became a member of the European Union in 2004, the requirement for this certification became unnecessary for civil weddings (Kolnagou and Kontoghiorghes 2009). In a number of Muslim countries including Lebanon, Iran, Saudi Arabia, Tunisia, United Arab Emirates, Bahrain, Qatar, and Gaza Strip (Samavat and Modell 2004;Inati et al 2006), the national premarital programs are mandatory and aimed at limiting carrier marriage. In most of these countries, nowadays, interruption of the pregnancy is permitted for severe fetal disorders but only within the fourth month of gestation.…”

Survival and Complications of Beta-Thalassemia in Lebanon

“…Lebanon has one of the highest carrier rates of thalassemia (around 2–3% carriership) with respect to its small population size (around 3.5 millions) [2]. β-Thalassemia is homogeneously distributed in Lebanon and is characterized by a very high consanguinity rate [2].…”

“…Lebanon has one of the highest carrier rates of thalassemia (around 2–3% carriership) with respect to its small population size (around 3.5 millions) [2]. β-Thalassemia is homogeneously distributed in Lebanon and is characterized by a very high consanguinity rate [2]. The prognosis of patients affected by β-thalassemia major (TM) improved after the introduction of regular blood transfusion regimens; however, complications and mortality related to iron overload started to emerge [3].…”

“…The prognosis of patients affected by β-thalassemia major (TM) improved after the introduction of regular blood transfusion regimens; however, complications and mortality related to iron overload started to emerge [3]. In Lebanon, treatment of thalassemic patients was done on individual basis and many patients could not even afford treatment and follow-up [2], until the end of 1994, when the Chronic Care Center (CCC) became operational. The CCC is a multidisciplinary center located in the suburbs of Beirut.…”