Abstract
Background: Hemoglobinopathies comprising of thalassemias and various hemoglobin (Hb) variants continue to plague the health system of India. Aims: To find out the prevalence of various hemoglobinopathies in the study population and to identify any association with the various ethnic groups residing in rural community of Darjeeling district, West Bengal. Materials and Methods: A community-based cross-sectional study was conducted in Naxalbari block of Darjeeling district, West Bengal from June 2011 to August 2011, involving hemoglobin variant screening by high-performance liquid chromatography (HPLC) method of 188 antenatal women, selected through multistage random sampling technique. Results: 26.6% of mothers had abnormal hemoglobin, the commonest being the Hemoglobin E (Hb E) trait (15.42%). The prevalence of homozygous HbE, HbE βthalassemia, β-thalassemia trait and hemoglobin S-trait in the studied population was 6.91%, 0.53%, 2.12% and 1.06% respectively. There was a single case of the rare hemoglobin J Meerut. Among those having abnormal hemoglobin, 66% belonged to one ethnic group, Rajbanshis. A statistically significant association was noted between Hb E syndrome (comprising of HbE trait, homozygous HbE, HbE-betathalassemia) and Rajbanshis ( P Conclusion: Findings suggest a high prevalence of hemoglobinopathies particularly Hb E in the studied population, especially Rajbanshis and warrant the need of wider community-based initiative for carrier detection and awareness generation.
Highlights
India is a vast country with considerable regional and ethnic diversity catering approximately a population of 1.2 billion
Among total 41.48% of population being represented by Rajbanshis, prevalence of Hemoglobin E (Hb E)-trait was 23.07%, Hb E-homozygous was 12.82%, HbE-beta thalassemia was 1.28% and beta thalassemia trait was 2.56%
Adivasis, who immigrated into Northern part of West Bengal for tea cultivation from Chotanagpur plateau, their results match with the residents of central east coast of India.[11,13]
Summary
India is a vast country with considerable regional and ethnic diversity catering approximately a population of 1.2 billion. The inherited hemoglobinopathies, namely hemoglobin (Hb) variants, thalassemia syndromes, hereditary persistence of fetal hemoglobin (HPHF) and their combinations show a wide variation of prevalence in the different regions and different populations. In India, nearly 30 million people are carriers of beta thalassemia and 7,000 babies with beta-thalassemia major are born every year.[1,2] The South-East Asia region (including India, Thailand, Indonesia) accounts for 50% of world’s thalassemia carriers[3] and for maximum of hemoglobin E (HbE) cases. Hb E ( -26 glutamine → lysine) is a structural variant of hemoglobin which in combination with thalassemia trait can manifest clinically as thalassemia minor, intermedia or major.
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