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在一个地中海贫血流行国家(土耳其)的非流行地区进行地中海贫血筛查:有必要吗?

Thalassaemia screening in a non-prevalent region of a prevalent country (Turkey): is it necessary?

作者信息

Acemoglu H, Beyhun N E, Vancelik S, Polat H, Guraksin A

机构信息

Department of Medical Education, Ataturk University School of Medicine, 25240 Erzurum, Turkey.

出版信息

Public Health. 2008 Jun;122(6):620-4. doi: 10.1016/j.puhe.2007.09.007. Epub 2008 Jan 28.

Abstract

OBJECTIVES

Haemoglobinopathies are the most widespread inherited disorders in the world, and are also common in Turkey. Haemoglobinopathies are preventable with control programmes. Therefore, the Ministry of Health initiated a control and prevention programme in 33 provinces in Turkey. The aim of this study was to determine the frequency of haemoglobinopathies in Erzurum as part of the programme mentioned above, and to discuss the need for premarital screening in a non-prevalent region (Erzurum) of a prevalent country (Turkey) as part of a national control programme.

STUDY DESIGN

Epidemiological and descriptive survey.

METHODS

This study was conducted between May 2005 and February 2006 in Erzurum. Subjects were couples who attended for premarital screening. All blood samples were measured by high-performance liquid chromatography (HPLC) to determine haemoglobinopathies.

RESULTS

In total, 1610 individuals were screened. The frequency of beta-thalassaemia trait was 0.68%. Haemoglobin D was the most common (0.12%) abnormal haemoglobin. Haemoglobins S, C and E were not detected. The frequency of beta-thalassaemia trait and other haemoglobinopathies in Erzurum was quite low compared with other provinces in Turkey.

CONCLUSIONS

Premarital haemoglobinopathy screening should not be mandatory in a non-prevalent region of a prevalent country as part of a national control programme. If screening is mandatory, it should be performed by total blood count or enzyme-linked immunosorbent assay, which are simple, rapid and less expensive than HPLC.

摘要

目的

血红蛋白病是世界上最普遍的遗传性疾病,在土耳其也很常见。通过控制项目,血红蛋白病是可以预防的。因此,土耳其卫生部在该国33个省份启动了一项控制和预防项目。本研究的目的是确定作为上述项目一部分的埃尔祖鲁姆地区血红蛋白病的发病率,并讨论在一个流行国家(土耳其)的非流行地区(埃尔祖鲁姆)作为国家控制项目一部分进行婚前筛查的必要性。

研究设计

流行病学和描述性调查。

方法

本研究于2005年5月至2006年2月在埃尔祖鲁姆进行。研究对象为前来进行婚前筛查的夫妇。所有血样均通过高效液相色谱法(HPLC)检测以确定是否患有血红蛋白病。

结果

总共筛查了1610人。β地中海贫血特征的发生率为0.68%。血红蛋白D是最常见的异常血红蛋白(0.12%)。未检测到血红蛋白S、C和E。与土耳其其他省份相比,埃尔祖鲁姆地区β地中海贫血特征和其他血红蛋白病的发生率相当低。

结论

作为国家控制项目的一部分,在一个流行国家的非流行地区,婚前血红蛋白病筛查不应作为强制性要求。如果筛查是强制性的,应该通过全血细胞计数或酶联免疫吸附测定来进行,这些方法简单、快速且比HPLC成本更低。

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