Academic journal article International Public Health Journal

Spectrum of Hemoglobinopathies and Evaluation of Beta-Thalassemia Trait in Tribal Land of Middle India

Academic journal article International Public Health Journal

Spectrum of Hemoglobinopathies and Evaluation of Beta-Thalassemia Trait in Tribal Land of Middle India

Article excerpt

Introduction

It is fascinating that about half of the indigenous people of the world, i. e. 84,326,240 as per 2001 census live in India and they constitute 8.2% of the total population of the country. The common terminology used for these people is aboriginese, indigenous people, tribal communities, and tribals; the primitive tribes/communities being the most backward of all people. There are about 635 tribes and subtribes including 75 primitive communities registered in 2001 census. These communities are highly vulnerable to hereditary hemolytic disorders that cause high degree of morbidity, infant and maternal mortality in India.

The malady of hemoglobinopathies in India is an important public health problem. Of the erythrocytic disorders of hemoglobin (Hb), beta (ß)-thalassemia is the most common among the general castes/ communities of India. In the North/North-westem part of India, a- and ß-thalassemia, and sickle cell and hemoglobin D significantly represents a public health problem. The ß-thalassemia is an inherited disorder in which the body is unable to synthesize adequate amount of hemoglobin due to a genetic defect that leads to absence or reduced synthesis of one or more polypeptide globin chains of hemoglobin molecule. This causes a spectrum of anomalies among the vulnerable individuals/communities leading to ineffective erythropoiesis. It has a wide geographical spread throughout the country, the highest prevalence being in the North-western, followed by North- eastern, and the lowest being in Southern parts of India (1, 2). With a wide range of variation of its prevalence in different communities of India, it would be interesting to explore the prevalence of ß- thalassemia among the under privileged indigenous people of India.

This research paper would considerably be of interest to the international scientific community to know that the indigenous communities that are endogamous in India were originally more or less completely free from hereditary ß-thalassemia. However, with the advent of penetration of invaders and/or migration of local/nonlocal nontribal communities and/or invaders from other parts of the world, especially from Mediterranean/gulf and/or South East Asian regions, the ß-thalassemia was introduced in them. In addition to knowing the pattern of hemoglobinopathies in a tertiary hospital in Central India, it would be fascinating to see geographical/ regional or ethnic variations with respect to distribution of ß-thalassemia trait in tribal land belt of India.

Methods

This study is a part of a major ongoing research project undertaken on 'Reproductive Outcome in Carrier Couples of Hemoglobinopathies in a Tertiary Hospital in Central India.' Ethical approval was obtained from the Human Ethical Committee, Regional Medical Research Centre for Tribals (ICMR), Jabalpur, Madhya Pradesh, Central India. A total of 1251 subjects suspected to be suffering from anemia/hemoglobinopathies referred from a tertiary hospital, Netaji Subhash Chandra Bose Medical College & Hospital, Jabalpur in Central India were screened for ß-thalassemia and other hemoglobinopathies during the period from March 2010 to March 2012.

About 2ml. of blood was taken intravenously under aseptical conditions using disposable syringes and needles with disodium salt of ethylene diamine tetra acetic acid (EDTA) as anticoagulant from each individual after taking informed/written consent and was free of blood transfusion for at least one month for screening of hemoglobinopathies and ß- thalassemia syndrome. Blood so collected was transported to laboratory at RMRCT, Jabalpur under wet-cold conditions for analysis. All the adopted procedures and techniques standardized in the laboratory were followed for diagnosis as described elsewhere (3, 4). Hematological indices were measured using MS59 Hematological Analyzer (Melet and Schloesing Laboratories, Cergy-Pontoise Cedex, France). Laboratory investigations were carried out following standard procedures. …

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