ZCZC
BSS-18
THALASEMIA-BANGLADESH TWO LAST DHAKA
Around 100,000 newborns are delivered each year with severe form of
thalassemia, most common with Mediterranean, South Asian, and African
ancestry. Symptoms will not show until the age of 6 months in most infants
with beta thalassemia and some types of alpha thalassemia.
The physicians say prevention is the only measure that can drastically
reduce the incidences of severe blood disorders. In affluent areas, the
prevention of thalassemia is largely dependent on prenatal care. If newly
pregnant couples come in for prenatal care, tests for blood disorders like
thalassemia are conducted, amongst many other crucial exams to ensure the
growth of a healthy embryo.
According to them, if the new pregnancy is tested positive for
thalassemia parents are counseled on their options, including early
termination. This form of screening and prevention has been very effective so
that no more than 20-30 new births with thalassemia occur as opposed to the
expected several hundreds.
After 6 months “normal” hemoglobin starts replacing the fetal type, and
symptoms may begin to appear with jaundice and pale skin, drowsiness and
fatigue, chest pain, cold hands and feet, shortness of breath, leg cramps,
rapid heartbeat, poor feeding, delayed growth, headaches, dizziness and
faintness and greater susceptibility to infections.
Skeletal deformities may result as the body tries to produce more bone
marrow. If there is too much iron, the body will try to absorb more iron to
compensate. Iron may also accumulate from blood transfusions. Excessive iron
can harm the spleen, heart, and liver.
According to the physicians, patients with hemoglobin H are more likely
to develop gallstones and an enlarged spleen. Untreated, the complications of
thalassemia can lead to organ failure. Thalassemia is likely to emerge as a
major health concern in South Asia and Bangladesh as it lies in the world’s
thalassemia belt.
In a comprehensive review paper on Thalassemias in South Asia: clinical
lessons learnt from Bangladesh, a group of physicians have depicted the
epidemiological aspects of thalassemias, mutation profile and current
treatment and management practices in the country by sharing the experience
of dealing with 1,178 cases over the 2009-2014 period in a specialized
thalassemia treatment centre.
They have also discussed the preventative strategies of thalassemias
from the context of Bangladesh which could be effective for other developing
countries. Having a thalassemia trait means that one may not have any
symptoms, but might pass that trait on to the children and increase their
risk for having thalassemia.
BSS/SAB/OG/UNICEF FEATURE/ARS/1719 hrs