SEARCHCOHORTepidemiology, public health

cohort·epidemiology, public health, hematology, pediatrics, obstetrics and gynecology·PMC10355052

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

Orphanet Journal of Rare Diseases · 6 authors, 5 centres

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TL;DR

The aim was to estimate the prevalence of hemoglobinopathies and their association with hemoglobin concentration and anemia.

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The aim was to estimate the prevalence of hemoglobinopathies and their association with hemoglobin concentration and anemia. The study provides the first community-based estimate in Bangladesh that comprehensively analyzes both alpha and beta thalassemia along with other hemoglobinopathies.

STUDY TYPE

cohort

SPECIALTY

epidemiology

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ORIGINAL PAPER

PMC10355052

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

Orphanet Journal of Rare Diseases

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ABSTRACT

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. Supplementary Information The online version contains supplementary material available at 10.1186/s13023-023-02821-3. Keywords: Hemoglobin disorder, Inherited blood disorder, Women, Children, Asia, Anemia

CITATION EXPORT

Amanda S Wendt, Joaquin Brintrup, Jillian L Waid et al.. Thalassemia and hemoglobinopathy prevalence in a community-based sample in Sylhet, Bangladesh. Orphanet Journal of Rare Diseases. (2023). https://doi.org/10.1186/s13023-023-02821-3

AUTHORS

6 · 5 CENTRES

Amanda S Wendt, Joaquin Brintrup, Jillian L Waid, Abdul Kader, Nathalie J Lambrecht, Sabine Gabrysch

1Research Department 2, Potsdam Institute for Climate Impact Research (PIK), Member of the Leibniz Association, Potsdam, Germany
2Heidelberg Institute of Global Health, Heidelberg University, Heidelberg, Germany
3Hemoglobin Laboratory, Department of Pediatrics, University Hospital Ulm, Ulm, Germany
4Bangladesh Country Office, Helen Keller International, Dhaka, Bangladesh
5Institute of Public Health, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität Zu Berlin, Berlin, Germany