Abstract
Few studies have addressed the risk of infection in transfusion-naïve thalassemia patients. We aimed to investigate whether transfusion-naïve thalassemia population has higher hospitalization rates for lower airway infection-related diseases than non-thalassemia population in children. A nationwide population-based retrospective cohort study was conducted using detailed medical records of the Taiwan National Health Insurance Research Database. Transfusion-naïve thalassemia patients were compared with a matched cohort at a ratio of 1:4. Data of the selected patients were adjusted for age, sex, and related comorbidities. We recorded the frequency of admissions or outpatient clinic visits for patients with a diagnosis of pneumonia or acute bronchitis/bronchiolitis. Based on our results, the hospitalization rates and incidence rate ratios of bronchitis/bronchiolitis and pneumonia for transfusion-naïve thalassemia children were all higher than those for non-thalassemia controls. Therefore, we conclude that transfusion-naïve thalassemia children are more likely to experience lower airway infections and have a higher probability of hospitalization for these conditions.
Highlights
Thalassemia is a common autosomal-recessive hereditary hemoglobinopathy, mainly characterized by a point mutation on globin gene expression [1]
Similar distributions occurred with sex, age, place of residence, income, and comorbidities, including asthma, diabetes mellitus (DM), chronic kidney disease (CKD), chronic lung disease, heart failure, and epilepsy between the thalassemia and non-thalassemia groups because both cohorts were matched for factors
The patients in the thalassemia group had a higher prevalence of acute bronchiolitis/bronchitis (92.88% vs. 87.60%, P = 0.003) and pneumonia (60.65 vs. 36.96%, P < 0.001) than those in the non-thalassemia group
Summary
Thalassemia is a common autosomal-recessive hereditary hemoglobinopathy, mainly characterized by a point mutation on globin gene expression [1]. Hemoglobin comprises four protein chains (two α and two β globin chains) that are assembled into a heterotetramer. In α-thalassemia and β-thalassemia, the production of the α and β globin chains is affected, respectively. Thalassemia is commonest among people of Italian, Greek, Middle Eastern, South Asian, and African descent [2]. In China, the prevalence of α-thalassemia, β-thalassemia, and α + β-thalassemia were estimated at 7.88, 2.21, and 0.48%, respectively [3]. The prevalence of α-thalassemia traits in Taiwan was 3.4% [4]
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