Prevalence of Thalassemia Traits and Iron Deficiency Anemia in Sindh, Pakistan

Abstract

Among microcytic hypochromic anemias, the most common disorders are iron deficiency anemia and co-pathological conditions such as α- or β-thalassemia (α- or β-thal) traits. The aim of the present study was to determine the frequency and prevalence of iron deficiency anemia and α- or β-thal traits based on clinical laboratory data across different ethnic groups in five districts of Sindh Province, Pakistan. The present retrospective study analyzed 3 years (2012–2015) of encoded and unlinked clinical laboratory data, and identified 3030 microcytic hypochromic anemia cases. The data contained complete blood counts (CBCs) with smear morphology examinations, serum ferritin levels, and hemoglobin (Hb) electrophoreses. After reviewing the data, 994 confirmed subjects (iron deficiency anemia and α- and β-thal traits) were then selected for the present study. The prevalence of α- and β-thal traits was highest in Badin district (35.27%), while the prevalence of iron deficiency anemia was highest in Larkana district (30.73%). According to the ethnic-wise distribution, higher numbers of α- and β-thal trait cases were seen in the Sindhi ethnic group [375 (64.21%) and 283 (69.02%), respectively] than in the other ethnic groups. In addition, a higher distribution of β-thal trait cases was observed in the Sindhi ethnic group [n = 327 (56%)] in α- and β-thal cases overall. Findings from the present study strongly suggested that screening is important not only for β-thal trait but also other traits as well. However, careful monitoring of CBC parameters, including red blood cell (RBC) indices and morphology, along with clinical findings are essential to diagnose carrier cases, especially in high prevalence areas.

Keywords:

• β-Thalassemia (β-thal) trait
• microcytic hypochromic anemia
• Pakistan
• thalassemia

Acknowledgments

We sincerely thank the staff of the Healthcare Molecular & Diagnostic Laboratory, Hyderabad, Pakistan, for data collection and analyses. We thank Dr. Arthur Brown [Government Official (Retired) of the Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand] for language editing of our manuscript. We highly appreciate the valuable comments and suggestions from two anonymous reviewers.

Disclosure statement

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this article.

Additional information

Funding

This study was supported by the Faculty of Medical Technology, Mahidol University, Mahidol, Thailand, and the Thailand Research Fund (TRF), Office of the Higher Education Commission to Pornlada Nuchnoi [MRG5480062].