Academic journal article International Public Health Journal

High Occurrence of G6PD Deficiency and Diversity of Hemoglobin Variants in Bhuyan Primitive Tribe of Sundargarh District of North-Western Orissa, India

Academic journal article International Public Health Journal

High Occurrence of G6PD Deficiency and Diversity of Hemoglobin Variants in Bhuyan Primitive Tribe of Sundargarh District of North-Western Orissa, India

Article excerpt

Introduction

Inherited hemoglobin (Hb) disorders are the global genetic and public health challenges. The highest frequency of sickle cell disease is encountered in tropical and subtropical regions, particularly in the sub-Saharan Africa, India and the Middle East (1). Sporadic cases of hemoglobin D also occur in many parts of the Indian subcontinent (2). With a prevalence rate of 3-5% of thalassemia carriers, the estimated carrier population in India would be 30-50 million (3).

The inherited erythrocytic deficiency of the enzyme glucose-6-phosphate dehydrogenase (G6PD) is an important metabolic, genetic and public health challenge in malaria-endemic areas of India (4). It is a predisposing factor in the causation of drug-induced hemolytic anemia and congenital non-spherocytic hemolytic disease. The deficient fibroblasts in humans suffer growth retardation and premature cellular senescence. In the absence of reduced glutathione (GSH), oxidative stress can lead to hemolysis of erythrocytes resulting in hemolytic anemia.

A great deal of variations in G6PD deficiency exists among different populations of the world. The variations can be explained in terms of evolutionary history and the mating practices (endogamous or nonendogamous nature) in a community. High prevalence can be explained in terms of the geographical spread of malaria. G6PD deficiency varies from 0% to 30.7% in different castes, tribes, and ethnic, religious and linguistic groups in India. The deficiency varies from 0.4% to 30.7% in the tribal communities of Orissa (4). Most of the individuals remain undiagnosed due to lack of awareness and nonavailability of testing facilities in India (4).

In view of the huge clinical burden of hemoglobinopathies on physicians, dismal health scenario, and limited genetic studies carried out on the tribal communities in India, this study presents the prevalence of hereditary hemolytic disorders, implications of endemic malaria in the light of biomedical and public health genetics, and genetic diversity in relation to Hb variants and G6PD deficiency in the Bhuyan primitive tribe, in Sundargarh district of Northwestern Orissa, India.

Methods

This study was a part of a major project undertaken on the ?Intervention for hereditary common hemolytic disorders among the major tribals of Sundargarh district of Orissa' carried out during the period from January 2000 to December 2004 with the financial support from the Ministry of Health and Family Welfare, Government of India through the Indian Council of Medical Research (ICMR), New Delhi. Ethical approval was obtained from the Human Ethical Committee, Regional Medical Research Centre (ICMR), Bhubaneswar (Orissa), India before initiation of the investigations.

Geographical location

The district lies in the North-western portion of the Orissa State in Central-Eastern region of India. It is bounded on the North by Jharkhand State, on the South by Jharsuguda, Sambalpur and Deogarh districts, on East and North-east by Keonjhar and Western Singhbhum districts of Orissa and Jharkhand, on the West and North-west Raigarh district of Chhatisgarh. The district lies between 21 degrees 35' N and 22 degrees 32' N latitudes and between 83 degrees 32' E and 85 degrees 22' E longitudes. Area of the district is 9712 sq. kms. The district headquarters is located at Sundargarh. This study was carried out in Sundargarh district of Orissa.

Background of the Bhuyan tribe

The Bhuyan tribe although originally belonged to one ethnic stock, but is now divided into three social and biological groups namely, the Hill Bhuyan (Pahari or Paudi Bhuyan), the Paik or Khandayat Bhuyan (Warrior Bhuyan), and Paraja Bhuyan (Common People), which are distinguished from each other on the basis of three grades of primitive culture in the state of Orissa. The Hill Bhuyan, the primitive and backward section, represents the hunting and food gathering stage of economic life along with the practice of rudimentary shifting cultivation and primitive culture. …

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