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[血红蛋白病的流行病学概况:一项横断面描述性索引病例研究]

[Epidemiological profile of hemoglobinopathies: a cross-sectional and descriptive index case study].

作者信息

Dahmani Fatima, Benkirane Souad, Kouzih Jaafar, Woumki Aziz, Mamad Hassan, Masrar Azlarab

机构信息

Équipe de Recherche en Hématologie, Laboratoire d'Hématologie, Faculté de Médecine et de Pharmacie, Université Mohammed V, Rabat, Maroc.

Laboratoire Central d'Hématologie, Centre Hospitalier Ibn Sina, Rabat, Maroc.

出版信息

Pan Afr Med J. 2017 Jun 29;27:150. doi: 10.11604/pamj.2017.27.150.11477. eCollection 2017.

Abstract

Hemoglobinopathies are congenital disorders resultimg from hemoglobin abnormalities. Major forms are often severe, their management is difficult and associated with a great psychosocial impact on patients and their families. They are classified as rare diseases and are still insufficiently known by health professionals. This lack of knowledge is at the origin of diagnostic errors, delay in their management and therefore high morbidity and mortality rate for these patients. In 2008, the World Health Organization (WHO) has published data on hemoglobinopathies epidemiology: more than 330.000 cases of hemoglobinopathy occur each year (83% of cases of sickle cell anemia, 17 % of cases of thalassemia). Hemoglobin disorders are responsible for approximately 3.4% of deaths among people under the age of 5. At the global level, approximately 7% of pregnant women would be carriers of a form of thalassemia and 1% of couples are at risk. However, they are relatively frequent in some regions of the globe where consanguineous marriages are common. We conducted a descriptive cross-sectional study based on two surveys, the first in May 2015 and the second in June of the same year. It was performed in the immunization days to deliver pneumococcal vaccine to the index cases and it was aimed to describe the epidemiological features of families at risk of hemoglobinopathies (index case study), whose index cases were treated in the Department of Pediatrics at the Provincial Hospital El Idrisi, Kenitra, Morocco. After having collected the epidemiological data from patients, laboratory tests were performed including: blood count with red blood cells morphological assessment using the MGG assay and automatic numbering of reticulocytes; hemoglobin electrophoresis at alkaline pH (8.8) and then at acid pH (5.4) on agarose gel and densitometric integration. 275 patients had laboratory profiles compatible with hemoglobinopathy. The majority of these patients were born to consanguineous marriages (83.1%) and came from the north regions of Morocco. This family survey allowed to identify families at risk with a high frequency of sickle cell anemia. Our results confirm the existence of hemoglobinopathies variants among Moroccan population.

摘要

血红蛋白病是由血红蛋白异常引起的先天性疾病。主要类型通常较为严重,其治疗困难,且对患者及其家庭造成巨大的心理社会影响。它们被归类为罕见疾病,卫生专业人员对其了解仍然不足。这种知识的缺乏导致了诊断错误、治疗延误,因此这些患者的发病率和死亡率很高。2008年,世界卫生组织(WHO)公布了血红蛋白病流行病学数据:每年发生超过33万例血红蛋白病(镰状细胞贫血病例占83%,地中海贫血病例占17%)。血红蛋白疾病约占5岁以下人群死亡人数的3.4%。在全球范围内,约7%的孕妇可能是某种形式地中海贫血的携带者,1%的夫妇有风险。然而,在全球一些近亲结婚常见的地区,它们相对较为普遍。我们基于两项调查开展了一项描述性横断面研究,第一次调查于2015年5月进行,第二次于同年6月进行。该研究在免疫接种日为索引病例接种肺炎球菌疫苗时开展,旨在描述有血红蛋白病风险的家庭(索引病例研究)的流行病学特征,其索引病例在摩洛哥凯尼特拉省伊德里斯i省立医院儿科接受治疗。在从患者收集流行病学数据后,进行了实验室检查,包括:通过MGG检测进行红细胞形态学评估的血细胞计数和网织红细胞自动计数;在碱性pH(8.8)然后在酸性pH(5.4)条件下在琼脂糖凝胶上进行血红蛋白电泳及光密度积分。275名患者的实验室检查结果符合血红蛋白病特征。这些患者大多数出生于近亲婚姻家庭(83.1%),来自摩洛哥北部地区。这项家庭调查有助于识别镰状细胞贫血高发的有风险家庭。我们的结果证实了摩洛哥人群中存在血红蛋白病变体。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f17f/5567958/e2af9b316ca9/PAMJ-27-150-g001.jpg

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