Thalassemia and iron deficiency among pregnant women attending antenatal care service at Khao Wong Hospital, Kalasin province

Abstract

In order to obtain an appropriate control measure for thalassemia and iron deficiency anemia, it is necessary to estimate the health burden in the relevant area. This study aimed to determine the prevalence of thalassemia and iron deficiency in pregnant women attending antenatal care service at Khaowong Hospital, Kalasin province, in which the majority of pregnant women is the “PhuTai” ethnic group. Blood samples taken from 302 pregnant women were investigated for hematological parameters using an automated blood cell counter to diagnose anemia. For the diagnosis of iron deficiency, measurement of ferritin was done by chemiluminescent immunoassay. Hb analysis using cellulose acetate electrophoresis and/or capillary zone electrophoresis was performed to diagnose b-thalassemia and abnormal hemoglobin (Hb).  Alpha-thalassemia genes including Hb Constant Spring (Hb CS) and Hb Pakse’ were identified by the polymerase chain reaction and related technologies. Of the 302 subjects, 36.4 % (95% CI = 31.0-42.1) had anemia, 42.0 % (95 % CI = 32.2-52.3) had iron deficiency and 17.0 % (95 % CI = 10.2-25.8) had iron deficiency anemia. Alpha-thalassemia 1 was found in 9.6% (95% CI = 6.5-13.5), comprising 9.3 % SEA deletion and 0.3 % THAI deletion. The prevalence of a-thalassemia 2 was 27.0 % (95 % CI = 18.6-36.8), comprising 14.0 % 3.7 kb deletion, 1.0 % 4.2 kb deletion and 12 % Hb CS. While 43.7 % (95 % CI = 38-0-49.5) of the subjects were Hb E carriers, only 0.3% (95 % CI = 0.0-1.8) were b-thalassemia carriers. The findings demonstrate the health burden in relation to thalassemia and iron deficiency anemia and indicate a need for appropriate measure to control the disease in this ethnic group.