Kadhim Kamal A, Baldawi Kadhim H, Lami Faris H
a Baghdad-Resafa Directorate of Health , Iraq Ministry of Health , Baghdad , Iraq.
b Directorate of Technical Affairs , Iraq Ministry of Health , Baghdad , Iraq.
Hemoglobin. 2017 May;41(3):164-168. doi: 10.1080/03630269.2017.1354877. Epub 2017 Aug 24.
Globally, thalassemia is the most common hereditary hemoglobinopathy, and occurs in 4.4/10,000 live births. In the developing world, the majority of patients die before the age of 20 years. In Iraq, there is little data on the epidemiology and burden of thalassemia. The objectives of this study were to determine the prevalence, incidence, trend, and complications of thalassemia patients in Iraq. All thalassemia patients registered in the accessible 16 (of the 19) thalassemia centers in Iraq until December 31 2015, were included. Data were acquired from patients' files and the centers' registries. The total number of registered thalassemia patients was 11,165 representing 66.3% of all registered hereditary anemias in these centers. The prevalence of thalassemia had increased from 33.5/100,000 in 2010 to 37.1/100,000 in 2015, while the incidence rate had decreased from 72.4/100,000 live births to 34.6/100,000 live births between 2010 and 2015. β-Thalassemia major (β-TM) represented 73.9% of all types of thalassemia. About 66.0% of patients were under 15 years old; 78.8% were offspring of parents who were related, and 55.9% had at least one complication. Respectively, 13.5 and 0.4% of thalassemia patients were infected with hepatitis C virus (HCV) and hepatitis B virus (HBV) at some point in their lives. No patients were infected with the human immune deficiency virus (HIV). In conclusion, the prevalence of thalassemia in Iraq is slightly increasing in spite of decreasing incidence. Screening for carriers, and intensified premarital screening and counseling programs, coupled with strong legislation can help in further decreasing incidence rate.
在全球范围内，地中海贫血是最常见的遗传性血红蛋白病，每10000例活产中就有4.4例发病。在发展中世界，大多数患者在20岁之前死亡。在伊拉克，关于地中海贫血的流行病学和负担的数据很少。本研究的目的是确定伊拉克地中海贫血患者的患病率、发病率、趋势和并发症。纳入了截至2015年12月31日在伊拉克19个地中海贫血中心中可访问的16个中心登记的所有地中海贫血患者。数据从患者档案和中心登记处获取。登记的地中海贫血患者总数为11165例，占这些中心所有登记遗传性贫血患者的66.3%。地中海贫血的患病率从2010年的33.5/10万增加到2015年的37.1/10万，而发病率在2010年至2015年间从每10000例活产72.4例降至34.6例。重型β地中海贫血（β-TM）占所有地中海贫血类型的73.9%。约66.0%的患者年龄在15岁以下；78.8%是近亲父母的后代，55.9%至少有一种并发症。分别有13.5%和0.4%的地中海贫血患者在其生命中的某个时刻感染了丙型肝炎病毒（HCV）和乙型肝炎病毒（HBV）。没有患者感染人类免疫缺陷病毒（HIV）。总之，尽管发病率下降，但伊拉克地中海贫血的患病率仍略有上升。对携带者进行筛查、加强婚前筛查和咨询项目，再加上强有力的立法，有助于进一步降低发病率。
