β-Thalassaemia and its Co-existence with Haemoglobin E and Haemoglobin S in Upper Assam Region of North Eastern India: A Hospital Based Study

Prevalence of beta thalassemia carriers in India: a systematic review and meta-analysis

A large number of studies have reported that the prevalence of beta thalassemia carriers in India varies by ethnic groups. The objective of this study was to conduct a systematic review of the published studies and conduct a meta-analysis to determine the prevalence of beta thalassaemia carriers in India. A PubMed database search using keywords "beta thalassaemia AND India" identified 1088 articles of which 69 articles were included in the review. Studies using diagnostic tests and methods recommended by the International Council for Standardization in Haematology were used for calculation of pooled prevalence. Pooled prevalence was calculated using a random effects model using Review Manager version 5.3. Studies had screened five categories of populations, that is, the general population; tribal groups, communities not belonging to tribal groups, persons with anemia, and persons referred with a suspicion of hemoglobinopathy. This heterogeneity contributed to a high pooled prevalence of beta thalassemia carriers of 8.23% (95% CI 7.36-9.10). Sub-group analysis however yielded 3.74% (95% CI 2.52-4.97) pooled prevalence of beta thalassemia carriers in the general population. It was 4.6% (95% CI 3.2-6.2) among tribal groups. Quality of prevalence studies was limited by methodological issues including non-random sampling methods, heterogeneity of population types screened, and lack of use of recommended diagnostic cut-offs. Prevalence of beta thalassemia carriers was similar in tribal populations and the general population, indicating the need to further investigate the prevalence of beta thalassemia carriers in tribal groups.

Epidemiology of malaria and anemia in high and low malaria-endemic North-Eastern districts of India

Anemia and malaria are the two major public health problems that lead to substantial morbidity and mortality. Malaria infection destroys erythrocytes, resulting in low hemoglobin (Hb) levels known as anemia. Here we report the determinants of anemia in high and low malaria-endemic areas that would help understand which parasite densities, age, and gender-associated low Hb levels. Therefore, a cross-sectional mass survey (n = 8,233) was conducted to screen anemia and malaria in high and low malaria-endemic districts (HMED and LMED) of North-East India. Axillary body temperature was measured using a digital thermometer. The prevalence of anemia was found to be 55.3% (4,547/8,233), of which 45.1% had mild (2,049/4,547), 52.1% moderate (2,367/4,547) and 2.9% had severe anemia (131/4,547). Among anemic, 70.8% (3,219/4,547) resided in LMED and the rest in HMED. The median age of the anemic population was 12 years (IQR: 7–30). Overall, malaria positivity was 8.9% (734/8,233), of which HMED shared 79.6% (584/734) and LMED 20.4% (150/734) malaria burden. The village-wise malaria frequency was concordant to asymptomatic malaria (10–20%), which showed that apparently all of the malaria cases were asymptomatic in HMED. LMED population had significantly lower Hb than HMED [standardized beta (β) = −0.067, p < 0.0001] and low-density Plasmodium infections had higher Hb levels than high-density infections (β = 0.113; p = 0.031). Women of reproductive age had higher odds for malaria (OR: 1.42; 95% CI: 1.00–2.05; p = 0.04). Females (β = −0.193; p < 0.0001) and febrile individuals (β = −0.029; p = 0.008) have shown lower Hb levels, but malaria positivity did not show any effect on Hb. Young children and women of reproductive age are prone to anemia and malaria. Although there was no relation between malaria with the occurrence of anemia, we found low-density Plasmodium infections, female gender, and LMED were potential determinants of Hb.

Prevalence of anemia among the women of childbearing age belonging to the tea garden community of Assam, India: A community-based study

Background

Anemia is a condition in which the number of red blood cells becomes insufficient to meet the body's physiologic needs. Anemia is one of the major public health problems in India. The aim of this study was to find the prevalence and determinants of anemia among the adult females of tea garden community of Assam.

Materials and Methods

A community-based cross-sectional study was conducted among 770 numbers of adult females belonging to the tea garden community. For all the samples, complete blood count, abnormal hemoglobin variants screening by high-performance liquid chromatography (HPLC), serum iron level, total iron binding capacity (TIBC), and serum ferritin concentrations were determined.

Results

Out of 770 patients, 19.7% were severely anemic. Hb S and β-thalassemia were the only hemoglobin types detected in the study. Hemoglobin type, mean corpuscular volume, TIBC, and serum ferritin level were the important determinants of anemia in the present study.

Conclusion

To reduce the burden of anemia among the adult females of tea garden community, the females should be screened periodically, and appropriate measures should be taken.

Haemoglobinopathies and β-Thalassaemia among the Tribals Working in the Tea Gardens of Assam, India

INTRODUCTION

Prevalence of haemoglobinopathies and β-thalassaemia are very high in India but information about its status among the tribals working in the tea gardens of Assam is very less.

AIM

The present study was carried out to determine the prevalence of haemoglobinopathies and β-thalassaemia among the tribals working in the tea gardens of Assam.

MATERIALS AND METHODS

A total 1204 samples from the tribals working in tea gardens of Assam were analysed for both Complete Blood Count (CBC) and High Pressure Liquid Chromatography (HPLC) for detection of haemoglobinopathies and β-thalassaemia.

RESULTS

This study showed that the prevalence of sickle cell anaemia and β-thalassaemia were very high among this population. Our results indicated a higher prevalence of β-thalassaemia (3.07%) among the Munda ethnic group and higher prevalence of sickle cell anaemia (4.73%) among the Lohar ethnic group. This was the first study to report the presence of HbE among the tribals working in the tea gardens of Assam.

CONCLUSION

Based on the present findings, sickle cell anaemia and β-thalassaemia were major health problem for the tribals working in the tea gardens of Assam. Proper diagnostic facilities for haemoglobinopathy and thalassaemia should be established in these areas, including establishment of haemoglobinopathy and thalassaemia database collection, haematological analysis laboratories, genetic counselling clinics, prenatal diagnosis centres and neonatal screening centres.