Prevalence of hemoglobinopathies among Malayali tribes of Jawadhu hills, Tiruvannamalai district, Tamil Nadu, India: a community-based cross-sectional study

ABSTRACT

Background

Hemoglobin (Hb), a red pigment of red blood cells (RBCs), carries oxygen from the lungs to different organs of the body and transports carbon dioxide back to the lungs. Any fault present in the Hb structure leads to undesirable functional effects of the RBCs, such as sickle cell anemia (SCA), thalassemia, etc. Hemoglobinopathies affect around 7% of people in both developed and developing countries globally. The aim of the present study was to determine the prevalence and carrier frequencies of hemoglobinopathies including SCA, thalassemia, and other abnormal Hb variants among Malayali tribes in the Jawadhu hills of Tiruvannamalai district, Tamil Nadu, India.

Methods

A community-based cross-sectional study was carried out among 443 Malayali tribes inhabiting the Jawadhu hills of Tiruvannamalai district from July 2022 to September 2022. The RBC indices were analyzed using an automated 5-part hematology analyzer (Mindray, BC-5150) and hemoglobin fractions were done using the HPLC system (Bio-Rad, D-10) following standard protocols.

Findings

A total of 443 participants were screened, out of whom 14.67% had an abnormal Hb fraction, 83.30% were identified as normal, and 2.03% were borderline. Notably, the study revealed a prevalence of 0.68% for the α-thalassemia trait and 13.99% for the β-thalassemia trait.

Interpretation

Haemoglobinopathies, specifically the β-thalassemia trait, were most prevalent among the Malayali tribal population of Tamil Nadu residing in the Jawadhu hills of Tiruvannamalai district. Hence, we need special attention for creating awareness, increasing hemoglobinopathies screening programs, and improving the importance of tribal health conditions by the government and non-governmental organizations (NGOs) for the betterment of the ethnic tribes.

KEYWORDS:

• Hemoglobinopathies
• thalassemia
• Malayali tribes
• Jawadhu Hills
• Tamil Nadu
• India

Acknowledgments

The authors acknowledged financial support from the Ministry of Health and Family Welfare, Government of India through the ICMR Extramural Research Grants, New Delhi. The authors would like to thank Mr. M. Venkatesan and Mr. Y. Isaac Arpudha Rangam (Project Senior Investigators), Ms. P. Pradeepa and Ms. A. Vinothini (Project Laboratory Technicians), Mr. V. Manoj Kumar (Project Data Entry Operator), Mr. P. Arun (Project Lab Attendant), Mr. G. Sundaramurthy and Mr. S. Vetrivel (Project Semi-Skilled Workers), Mrs. S. Dhana Priya Vadhani (Technician-2), and Mrs. V. M. Girija Lakshmi (Technical Officer-C) who were immensely involved in the field survey activities, data collection, biological sample collection, processing, and analysis. The authors are also grateful to Primary Health Centre (PHC) doctors and community leaders of the Malayali tribes for their kind support and cooperation.

We sincerely acknowledged our thanks and gratitude to our Head of the Institute ‘The Director, ICMR-National Institute of Epidemiology (ICMR-NIE), Chennai’ for his constant and consistent support and approval for overall field surveillance activities. Similarly, we also sincerely acknowledged our gratitude to ‘The Director, Directorate of Public Health & Preventive Medicine (DPH&PM), Government of Tamil Nadu’, ‘The Principal Chief Conservator of Forests (PCCF), and The District Forest Office (DFO), Government of Tamil Nadu’, ‘The Tribal Welfare Department (TWD), Government of Tamil Nadu’, and ‘The District Collectorate (DC), Tiruvannamalai District’ for their overall support and coordination in all our field public health survey activities. Finally, we extend our special thanks to all the study participants who consented and cooperated to participate in the study.

Disclosure statement

All the authors declared ‘No Conflicts of Interest’ in preparation of this original research manuscript, and publication of the study report.

Author contributions

BG and SKA conceptualized the work; TR and BG performed the literature search. TR wrote the first draft of the manuscript. BG carried out the first draft revision. SD and VR performed the data analysis. SKA, AN, SR, and HK gave critical inputs. BG, TR, SKA, SD, VR, JY, AN, SR, and HK performed the review-editing of the manuscript and revisions. The decision of the final version is agreed upon by all the authors.

Additional information

Funding

This study was funded by the ICMR Extramural Research grant with ICMR Extramural Research Grants No. Tribal/CFP/4/2018-ECD-II Dated 14/05/2019 [IRIS ID No. 2018-3075].