SCREENING FOR β -THALASSEMIA TRAIT OR OTHER HEMOGLOBINOPATHIES IN FAMILIES OF THALASSEMIA MAJOR PATIENTS
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Keywords
Abstract
Objective:
Screening of extended families including first degree relative of Thalassemia major children for the presence of β Thalassemia minor or other hemoglobinopathies
Study Design: Cross-sectional descriptive study.
Setting: Punjab Thalassemia Prevention Program, Nishtar Hospital Multan.
Period: Six months,1st October 2023 to 1st April 2024.
Material and Methods:
CBC’s and peripheral smears of 11310 first degree relatives from 138 families with index case of thalassemia major, were done. Those (7299) with MCV and MCH less than 75fl and 25pg respectively and had microcytic hypochromic blood picture on peripheral smear, were included in the study. Their 2cc blood sample was taken for Hb electrophoresis. Those whose Hb A2 levels came out to be > 3.5% were labelled as beta thalassemia carriers, those with HbA2 levels 3.0-3.4% were considered inconclusive/ borderline and their serum ferritin levels were done to screen IDA. If they were iron deficient, they were given iron supplements for six month and Hb electrophoresis was repeated after 6 months.
Results:
Out of 7299 extended family members of beta thalassemia major patients.26.67% were beta thalassemia carriers (beta thalassemia trait), 68.78% were non carrier for beta thalassemia trait, 4.13% were repeat or borderline, while 0.39% have other hemoglobinopathies.
Conclusions: In third world countries like us cascade screening seems to be one of the most cost-effective approaches to identify carriers of beta thalassemia.
References
2. A. Victor Hoffbrand , Douglas R. Higgs , David M. Keeling , Atul B. Mehta Postgraduate Hematology. 7th ed.UK: Blackwell Publishing Ltd; 2015.
3. Robert T. Means Jr., Daniel A. Arber, Bertil E. Glader, Frederick R. Appelbaum , George M. Rodgers , Angela Dispenzieri et al.Wintrobe”s Clinical Haematology: Print + eBook with Multimedia. 15th Edition: Wolters Kluwers Health Pharma Solutions (Europe) Ltd ; 2023.
4. Giovanni Caocci, Maria Grazia Orofino, Adriana Vacca, Antonio Piroddi, Eugenia Piras, Maria Carmen Addari et al. Long-term survival of beta thalassemia major patients treated with hematopoietic stem cell transplantation compared with survival with conventional treatment. American j of Haematology Dec 2017; Volume 92, Issue 12 Pages 1303-131
5. Telfer17. P, Coen PG, Christou S, Hadjigavriel M, Kolnakou A, Pangalou E, et al. Survival of medically treated thalassaemia patients in Cyprus. Trends and risk factors over the period 1980-2004. Haematologica 2006; 91: 1187-92. PMID.
6. Ahmed S, Saleem M, Modell B et al. Screening extended families for genetic haemoglobin disorders in Pakistan. N Engl J Med 2002; 347:1162–8.
7. Ahmed S. Genetic Haemoglobin Disorders in Pakistan. National Journal of Health Sciences, 2017, Vol. 2 No. 3.
8. Tamary H, Dgany O. Alpha-thalassemia. 2005 Nov 1 [updated 2020 Oct 1]. In: Adam MP, Mirzaa GM, Pagon RA, Wallace SE, bean LJH, Gripp KW, et al., editors. Gene Reviews® [internet]. Seattle (WA): University of Washington, Seattle; 1993- 2023.
9. Motiani A, Sonagra AD. Laboratory evaluation of alpha thalassemia. In: Stat Pearls [internet]. Treasure Islan FL: Stat Pearls Publishing; 2023.
10. A.M. Hood, A. Chaman, Y. Chen et al. Psychological challenges and quality of life in Pakistani parents of children living with thalassemia Journal of Pediatric Nursing 76 (2024) 132–139.
11. Khan S, Iqbal I, Sheikh MA, Kamran Ishfaq, et al. Detection of Thalassemia Trait in Family Members of Children having Beta-Thalassemia and its role in prevention of thalassaemia Pak Pediatric J 2016; 40(2): 100-103.
12. Ismail M. Screening extended families for identification of β-thalassemia carriers: an experience from north Maharashtra region Int J Community Med Public Health. 2022 Mar;9(3):1459-1463
13. .Naresh D.S. et al Screening of Extended Family Members of Thalassemia Major Children as a Thalassemia Preventive Strategy Ethiop J Health Sci. Vol. 32, No. 6 November 2022 12031210. doi: 10.4314/ejhs.v32i6.18.
