Thalassemias in South Asia: clinical lessons learnt from Bangladesh

Abstract

Thalassemias are emerging as a global public health concern. Due to remarkable success in the reduction of childhood mortality by controlling infectious diseases in developing countries, thalassemias are likely to be a major public health concern in the coming decades in South Asia. Despite the fact that Bangladesh lies in the world's thalassemia belt, the information on different aspects (epidemiology, clinical course, mortality, complications and treatment outcomes) of thalassemias is lacking. In this comprehensive review, the aim is to to depict the epidemiological aspects of thalassemias, mutation profile and current treatment and management practices in the country by sharing the experience of dealing with 1178 cases over 2009-2014 time periods in a specialized thalassemia treatment centre. We have also discussed the preventative strategies of thalassemias from the context of Bangladesh which could be effective for other developing countries.

Keywords: Bangladesh; Beta thalassemia; Beta thalassemia major; HbE beta thalassemia; Hemoglobinopathies; Non-transfusion dependent thalassemia; Thalassemia trait; Transfusion dependent thalassemia.