Thalassemia, a hereditary blood disorder that affects the body’s ability to produce hemoglobin and red blood cells, is one of the worst type of diseases causing severe anemia among children in Bangladesh and elsewhere across the world.

According to Bangladesh Thalassemia Foundation, a Thalassemia patient needs 1-2 bags of blood every month to survive, and the disease is very common in Bangladesh. At least 7% of the Bangladesh population is thalassemia carriers, it said.

The BTF also said that every year 7,000 new babies are born with thalassemia in Bangladesh, and the disease can be easily preventable with proper knowledge and awareness. A person with thalassemia has too few red blood cells and too little hemoglobin. The impact can range from mild to severe and life-threatening, an expert said.

Eminent physicians often suggest conducting blood tests of both male and female before getting married only to ensure that a baby is not born with thalassemia, a genetically inherited deadly disease transmitted to babies by parents. They also suggest avoiding intra-family marriage to keep them away from giving birth to a Thalassemia, trait infant.

Emergence of Thalassemia

‘Both male and female should go for a detailed blood test before getting married to find out the symptoms of the possible emergence of the chronic disease Thalassemia,’ Secretary General at Bangladesh Thalassemia Foundation M Abdur Rahim said.

A simple health check-up for Thalassaemia carrier status before starting a family can save any future child from becoming a patient of Thalassaemia Major, unending cycle of injections, suffering, and misery, says the eminent hematologist.

‘The ‘Thalassemia major’ occurs when a person inherits two Thalassemia genes, one from each parent. Both parents may have ‘Thalassemia minor,’ but when two individuals who have ‘Thalassemia minor’ get married, there is a 25% possibility that any pregnancy can result in a child with Thalassemia major,’ Rahim said.

Director of Dhaka Shishu Hospital Prof Manzoor Hussain said: ‘If we can introduce the anti-natal screening system in our country, we can decrease the rate of the disease by terminating the Thalassemia positive unborn.’

The physicians say prevention is the only measure that can drastically reduce the incidences of severe blood disorders. In affluent areas, the prevention of thalassemia is largely dependent on prenatal care. If newly pregnant couples come in for prenatal care, tests for blood disorders like thalassemia are conducted, amongst many other crucial exams to ensure the growth of a healthy embryo.

According to them, if the new pregnancy is tested positive for thalassemia parents are counseled on their options, including early termination. This form of screening and prevention has been very effective so that no more than 20-30 new births with thalassemia occur as opposed to the expected several hundred.

After 6 months ‘normal’ hemoglobin starts replacing the fetal type, and symptoms may begin to appear with jaundice and pale skin, drowsiness and fatigue, chest pain, cold hands and feet, shortness of breath, leg cramps, rapid heartbeat, poor feeding, delayed growth, headaches, dizziness and faintness and greater susceptibility to infections.

According to the physicians, patients with hemoglobin H are more likely to develop gallstones and an enlarged spleen. Untreated, the complications of thalassemia can lead to organ failure. Thalassemia is likely to emerge as a major health concern in South Asia and Bangladesh as it lies in the world’s thalassemia belt.

In a comprehensive review paper on Thalassemias in South Asia: clinical lessons learned from Bangladesh, a group of physicians have depicted the epidemiological aspects of thalassemias, mutation profile and current treatment and management practices in the country by sharing the experience of dealing with 1,178 cases over the 2009-2014 period in a specialized thalassemia treatment center.

They have also discussed the preventative strategies of thalassemias from the context of Bangladesh which could be effective for other developing countries. Having a thalassemia trait means that one may not have any symptoms, but might pass that trait on to the children and increase their risk for having thalassemia.