Eastern Mediterranean Health Journal [2023; Vol.29, Issue 6]

Eastern Mediterranean Health Journal is the official health journal published by the Eastern Mediterranean Regional Office of the World Health Organization. It is a forum for the presentation and promotion of new policies and initiatives in health services; and for the exchange of ideas concepts epidemiological data research findings and other information with special reference to the Eastern Mediterranean Region. It addresses all members of the health profession medical and other health educational institutes interested NGOs WHO Collaborating Centres and individuals within and outside the Region

المجلة الصحية لشرق المتوسط هى المجلة الرسمية التى تصدرعن المكتب الاقليمى لشرق المتوسط بمنظمة الصحة العالمية. وهى منبر لتقديم السياسات والمبادرات الجديدة فى الصحة العامة والخدمات الصحية والترويج لها، و لتبادل الاراء و المفاهيم والمعطيات الوبائية ونتائج الابحاث وغير ذلك من المعلومات، و خاصة ما يتعلق منها باقليم شرق المتوسط. وهى موجهة الى كل اعضاء المهن الصحية، والكليات الطبية وسائر المعاهد التعليمية، و كذا المنظمات غير الحكومية المعنية، والمراكز المتعاونة مع منظمة الصحة العالمية والافراد المهتمين بالصحة فى الاقليم و خارجه

La Revue de Santé de la Méditerranée Orientale est une revue de santé officielle publiée par le Bureau régional de l’Organisation mondiale de la Santé pour la Méditerranée orientale. Elle offre une tribune pour la présentation et la promotion de nouvelles politiques et initiatives dans le domaine de la santé publique et des services de santé ainsi qu’à l’échange d’idées de concepts de données épidémiologiques de résultats de recherches et d’autres informations se rapportant plus particulièrement à la Région de la Méditerranée orientale. Elle s’adresse à tous les professionnels de la santé aux membres des instituts médicaux et autres instituts de formation médico-sanitaire aux ONG Centres collaborateurs de l’OMS et personnes concernés au sein et hors de la Région

Regional desk review of haemoglobinopathies with an emphasis on thalassaemia and accessibility and availability of safe blood and blood products as per these patients’ requirement in South-East Asia under universal health coverage

Disorders of haemoglobin are one of the most common monogenic disorders prevalent across the world. While sickle cell disorders are more prevalent worldwide, the thalas saemic syndromes including α and β-thalassaemia and haemoglobin-E disease are associated with high prevalence rates in the countries of the WHO SEA Region. This desk review was performed using data from thalassaemia societies, the nodal authorities dealing with blood product support, data published in the literature and data from WHO. Member states may find it useful to leverage the information contained herein to develop national action plans to address this problem in all possible ways including access to sufficient and secure blood and blood products, and safe transfusion services, as a vital part of achieving universal health coverage.

Prevalence of thalassaemia, iron-deficiency anaemia and glucose-6-phosphate dehydrogenase deficiency among Arab migrating nomad children, southern Islamic Republic of Iran

This study investigated the prevalence of iron-deficiency anaemia, glucose-6-phosphate dehydrogenase [G6PD]deficiency and beta-thalassaemia trait among Arab migrating nomad children in southern Islamic Republic of Iran. Blood samples were analysed from 134 schoolchildren aged < 18 years [51 males, 83 females]. Low serum ferritin [< 12 ng/dL] was present in 17.9% of children [21.7% in females and 11.8% in males]. Low haemoglobin [Hb]correlated significantly with a low serum ferritin. Only 1 child had G6PD deficiency. A total of 9.7% of children had HbA2 >/= 3.5 g/ dL, indicating beta-thalassaemia trait [10.8% in females and 7.8% in males]. Mean serum iron, serum ferritin and total iron binding capacity were similar in males and females.Serum ferritin index was as accurate as Hb index in the diagnosis of iron-deficiency anaemia. A high prevalence of beta-thalassaemia trait was the major potential risk factor in this population

La présente étude a évalué la prévalence de l'anémie ferriprive,du déficit en glucose-6-phosphate déshydrogénase et de la bêta-thalassémie mineure chez des enfants nomades et migrants arabes dans le sud de la République islamique d'Iran. Des échantillons de sang de 134 écoliers de moins de 18 ans ont été analysés [51 garçons, 83 filles]. Des taux de ferritine sérique faibles [< 12 ng/dL] ont été observés chez 17,9 % des enfants [21,7 % chez les filles et 11,8 % chez les garçons]. Un faible taux d'hémoglobine [Hb] était significativement corrélé à un faible taux de ferritine sérique. Seul un enfant était atteint de déficit en glucose-6-phosphate déshydrogénase. Au total,9,7 % des enfants présentaient un taux d’HbA2 supérieur ou égal à 3,5 g/dL, signe d'une bêta-thalassémie mineure [10,8 % des filles et 7,8 % des garçons]. Le taux moyen de fer sérique, de la ferritine sérique et la capacité de liaison du fer total étaient similaires chez les deux sexes. Le taux de ferritine sérique était aussi précis que le taux d’Hb pour le diagnostic de l'anémie ferriprive. La forte prévalence de la bêta-thalassémie mineure représentait le principal facteur de risque dans cette population

Thalassaemia and glucose-6-phosphate dehydrogenase deficiency in sickle-cell disorder patients in Taiz, Yemen

A pilot study was conducted to determine the prevalence and haematological characteristics of the interaction between thalassaemia or/and glucose-6-phosphate dehydrogenase [G6PD] deficiency in patients with sickle-cell disorder [SCD] in Taiz city, Yemen, where the prevalence of sickle-cell trait [HbAS] is 8.2%. Blood samples were collected from 31 SCD patients. Complete blood count and haemoglobin electrophoresis, G6PD activity and serum ferritin were determined. Thalassaemia was found in 6 patients [19.4%] and G6PD deficiency [6 mild and 1 severe] was detected in 7 patients [22.6%] The frequency of thalassaemia and/or G6PD deficiency with SCD was high and this may have an effect on the seventy of the clinical course of SCD in Taiz. The study should be repeated with DNA analysis to define the nature of the globin gene defect and to clarify its role in the severity of SCD

Outcome and management of pregnancy in women with thalassaemia in Cyprus

We describe the management and clinical outcome of pregnancies among 100 Greek Cypriot women with thalassaemia: 88 with thalassaemia major and 12 with thalassaemia intermedia. A total of 152 successful pregnancies and 161 deliveries were included. All patients had endocrine assessment and frequent ferritin measurements. Multiple successful pregnancies included 7 twins and 1 triple pregnancy. Pregnant thalassaemics required significantly larger amount of total blood transfusion during pregnancy. There was a statistically significant increase in the ferritin levels during pregnancy, and levels remained significantly higher after pregnancy. Most pregnancies resulted in delivery of full-term healthy babies, and obstetric complications were rare, although some problems were encountered

High-dose deferoxamine treatment [intravenous] for thalassaemia patients with cardiac complications

As a means to manage cardiac conditions, we determined the effects of high-dose intravenous [IV] deferoxamine in 15 thalassaemia patients with cardiomyopathy and high ferritin and haemoglobin levels. The patients received IV deferoxamine, 130 mg/kg per day over 10-14 hours [maximum 5 g] for 5 consecutive days. All patients underwent a full evaluation before receiving deferoxamine, and 2 days and 1 month after completing the treatment. Visual and auditory examinations were done to detect any side-effects. After treatment, cardiovascular symptoms decreased considerably and systolic function showed significant improvement, but there was no significant effect on diastolic function, electro-cardiography and physical findings. There were no significant side-effects reported

Monte Carlo simulation on the effect of different approaches to thalassaemia on gene frequency

We used computer simulation to determine variation in gene, heterozygous and homozygous frequencies induced by 4 different approaches to thalassaemia. These were: supportive therapy only; treat homozygous patients with a hypothetical modality phenotypically only; abort all homozygous fetuses; and prevent marriage between gene carriers. Gene frequency becomes constant with the second or the fourth strategy, and falls over time with the first or the third strategy. Heterozygous frequency varies in parallel with gene frequency. Using the first strategy, homozygous frequency falls over time; with the second strategy it becomes constant; and with the third and fourth strategies it falls to zero after the first generation. No matter which strategy is used, the population gene frequency, in the worst case, will remain constant over time